Metatarsal region

The metatarsal region is the part of the forefoot consisting of five metatarsal bones and associated soft tissues. To learn more about metatarsal bones, please visit the link provided.

The upper part of the metatarsal region, known as the DORSAL METATARSAL REGION, contains several important structures. These structures, from deep to superficial, include:

• Dorsal interosseus muscles, which originate from the sides of the metatarsal bones and insert into the extensor hoods and bases of the proximal phalanges.

• Tendons of the extensor digitorum longus, extensor hallucis longus, and extensor digitorum brevis muscles, which pass through the dorsal metatarsal region before the phalanges.

• Dorsalis pedis artery, which continues distally from the anterior tibial artery. It descends in the dorsal metatarsal region as the first dorsal metatarsal artery and dips between the two heads of the first dorsal interosseus muscle to connect with the deep plantar arterial arch in the sole. The dorsalis pedis artery also gives off an arcuate branch in the dorsal metatarsal region, which supplies the remaining lateral dorsal metatarsal arteries. Veins usually accompany the arteries.

• Deep peroneal nerve, which accompanies the dorsalis pedis artery in the dorsal metatarsal region. It provides cutaneous innervation to the skin in the first interdigital space.

• Dorsal venous arch, located in the superficial fascia of the dorsal metatarsal region, giving rise to great and small saphenous veins (medially and laterally, respectively).

• Various superficial cutaneous nerves within the superficial fascia, including the superficial peroneal nerve (innervating the dorsum of the foot), the cutaneous ending of deep peroneal (innervating the skin of the first interdigital space), the sural nerve (innervating the lateral border of the foot), and the saphenous nerve (innervating the medial border and heel of the foot).

The lower part of the metatarsal region, known as the PLANTAR METATARSAL REGION, contains several important muscles. These structures, from deep to superficial, include:

• Plantar interosseus muscles, originating from the medial sides of the metatarsal bones and inserting into the extensor hoods and bases of the proximal phalanges. Additionally, the tendon of the peroneus longus muscle can be observed running laterally to medially, clasping the transverse arch of the foot.

• Adductor hallucis, consisting of the oblique head (originating from the bases of the metatarsals) and the transverse head (originating from the ligaments at the metatarsophalangeal joints). Flexor hallucis brevis and flexor digiti minimi brevis are also present, lying on the medial and lateral sides of the first and fifth metatarsal bones, respectively.

• The long tendons of the flexor hallucis longus and flexor digitorum longus pass through the plantar metatarsal region, with lumbricals arising from these tendons.

• More superficially, the tendons of the abductor hallucis, abductor digiti minimi, and flexor digitorum brevis can be observed in the plantar metatarsal region.

• The most superficially visible structures include the plantar aponeurosis and the plantar fat pads.

• Vital vessels in the plantar metatarsal region consist of the plantar metatarsal (and digital) arteries and perforating arteries, originating from the deep plantar arch.

• The significant nerves in the plantar metatarsal region comprise the common plantar digital and proper plantar digital nerves, emerging as superficial branches of the medial and lateral plantar nerves. The deep branches of these nerves are responsible for motor function and provide innervation to the muscles of the sole of the foot.