metatarsals

Metatarsals are the five long bones of the foot located between the tarsal bones of the hindfoot and midfoot and the proximal phalanges of the toes. They are numbered I to V from medial to lateral, corresponding roughly to the big toe through the little toe. Each metatarsal consists of a base (proximal), a shaft (body), and a head (distal) that forms the metatarsophalangeal joints with the corresponding proximal phalanges. The first metatarsal base articulates with the medial cuneiform, and the bases of the others articulate with nearby tarsal bones, predominantly the cuneiforms and the cuboid. The heads articulate with the proximal phalanges, and the first metatarsophalangeal joint typically bears two plantar sesamoid bones.

Functionally, the metatarsals transmit load from the midfoot to the toes during stance and gait and serve as lever arms to facilitate push-off. They also contribute to the foot’s arches, including the transverse and longitudinal arches, helping maintain foot stability during movement.

Clinical notes include common injuries such as metatarsal fractures and stress fractures, particularly in athletes. The 5th metatarsal is prone to avulsion or Jones-type fractures. Metatarsalgia refers to pain at the metatarsal heads, often related to overload or alignment issues. Turf toe describes a sprain of the first MTP joint. Treatment ranges from rest and immobilization to surgery for displaced fractures or instability, with rehabilitation focusing on restoring range of motion and foot strength.

Developmentally, each metatarsal ossifies from a primary center in the shaft, with distal epiphyseal ossification occurring later in development. Normal variants include a relatively long second metatarsal (Morton’s toe) and rare supernumerary metatarsals.