TAESO-METATARSAL ARTICULATIONS. 165 



third metatarsal bone articulates with the extremity of the external cunei- 

 form ; and the last two with the cuboid bone. The articulations are furnished 

 with synovial membranes, and tha boned are held in contact by dorsal, plantar, 

 and iiiterosseous ligaments. 



The dorsal tarso-metatarsal ligaments are flat thin bands of parallel fibres, 

 which pass from behind forwards, connecting the contiguous extremities of 

 the bones before mentioned. Thus the first metatarsal bone receives a broad 

 thin band from the corresponding cuneiform bone ; the second receives 

 three, which converge to its upper surface, one passing from each cuneiform 

 bone ; the third has one from the external cuneiform bone ; and, finally, 

 the last two are bound by a fasciculus to each from the cuboid bone, and 

 by fibres from the external cuneiform to the fourth metatarsal bone. The 

 plantar ligaments are less regular ; the bands of the first and second toes are 

 more strongly marked than the corresponding ligaments on the dorsal sur- 

 face ; and those of the fourth and fifth toes, which are merely a few- 

 scattered fibres passing to the cuboid, receive support from the sheath of the 

 peroneous longus muscle. Ligamentous bands stretch in an oblique or trans- 

 verse direction from the internal cuneiform to the second and third meta- 

 tarsal bones, and from the external cuneiform to the fifth metatarsal. 



The interosseous ligaments are longitudinal in direction, and have especial 

 interest, because of the resistance which they oppose to the surgeon in 

 separating the metatarsus from the tarsus, in consequence of their deep 

 position between the bones, a. The internal and largest of these lies to 

 the outer side of the first cuneiform bone, and extends from this bone to 

 the neighbouring side of the second metatarsal, close to the articular sur- 

 face, b. The external iuterosseous ligament separates the articulation of 

 the fourth and fifth metatarsal bones from the rest. It connects the outer 

 side of the external cuneiform bone to the same side of the third, and very 

 strongly to the inner side of the fourth metatarsal. c. Occasionally some 

 fibres, of less strength and importance than the preceding, are observable on 

 the outer side of the second metatarsal bone, connecting it to the middle 

 cuneiform. 



The interosseous ligaments are found to vary somewhat in their connections from 

 those here stated, being sometimes attached at once to the contiguous sides of two 

 tarsal and two metatarsal bones. Attention was first particularly directed to these 

 ligaments by M. Lisfranc, in connection with the amputation of the foot through the 

 tarso-metatarsal articulation. See "Manuel des Operations Chirurgicales, &c. Par 

 J. Coster." 3rd edit. Paris, 1829. 



Synovial membranes. There are three synovial membranes in this 

 irregular series of articulations, a. One belongs to the internal cuneiform 

 and the first metatarsal bone : the joint formed between these two bones is 

 altogether separate and out of the range of the rest. b. A second sy no vial 

 membrane is placed between the cuboid and the fourth and fifth metatarsal 

 bones; this is isolated on the inner side by the external interosseous liga* 

 ment. c. The third or middle one is placed between the middle and external 

 cuneiform and the second and third metatarsal bones, and is prolonged 

 between the two last-named bones, as well as sometimes between the third 

 and fourth metatarsal bones. The disposition of this last synovial mem- 

 brane is subject to variation. 



CONNECTION OF THE METATARSAL BONES WITH ONE ANOTHER. The .meta- 

 tarsal bones are bound together at their tarsal and digital ends ; very firmly 

 in the former, and loosely in the latter situation. 



The tarsal ends or bases of the four outer bones articulate with each other, 



