intermetatarsal

Intermetatarsal refers to structures and spaces situated between the metatarsal bones of the forefoot. In anatomical usage, the term describes the intermetatarsal spaces and the tissues that traverse them, including ligaments, nerves, and capsules. The intermetatarsal region helps stabilize the forefoot and contributes to the distribution of loads across the ball of the foot during gait.

Anatomy in this area includes the plantar and dorsal intermetatarsal ligaments, which connect adjacent metatarsal heads and help maintain the transverse arch. The deep transverse metatarsal ligament is a key plantar ligament spanning the bases of neighboring metatarsals. The intermetatarsal spaces also contain neural and vascular elements, notably branches of the plantar digital nerves that provide sensation to the toes.

Clinically, the intermetatarsal region is associated with several conditions. Morton's neuroma is a common problem involving entrapment or irritation of the common plantar digital nerve within the intermetatarsal space, most frequently between the third and fourth toes. Intermetatarsal bursitis, ganglia, and plantar plate injuries can also arise in this area, often related to overuse, footwear, or forefoot deformities.

Diagnosis generally relies on clinical assessment supplemented by imaging as needed. Plain radiographs evaluate bone alignment and metatarsal lengths, while ultrasound or MRI can visualize soft tissue structures and neuromas. Treatment ranges from conservative approaches—shoe modifications, orthotics, physical therapy, NSAIDs, and injections—to surgical intervention for persistent neuroma, ligament injury, or significant forefoot deformities.