Gao Zhuan, Li Yue, Yang Yu-Jie, Guo Li-Ying, Yu Shuang-Fei, Wang Jing, Li Jing
Academy of Clinical Medicine, Jining Medical University, Jining, 272067, China.
Academy of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China.
Surg Radiol Anat. 2025 Apr 30;47(1):133. doi: 10.1007/s00276-025-03651-7.
To clarify the anatomical characteristics of the lateral plantar ligament (LPL) of the transverse metatarsal arch (TMA) in the population of southwest Shandong Province, so as to complement the anatomical structures of the midfoot and Lisfranc joint complexes.
A total of 100 adult lower limbs were dissected and the types of LPL were divided according to their insertions, among them, 63 were (63%) and 37 were female (37%); 50 were on the left side (50%) and 50 were on the right side (50%). The fiber bundle length, origin width, insertion width, and thickness of the LPL were measured.
(1) According to the insertions of the LPL, they were divided into: ① Type I, the LPL was inserted at the base of the second metatarsal (M2) in 47 cases; ② Type II, the LPL was inserted at the base of M2 and fused with tibialis posterior tendon (TPT) in 16 cases; ③ Type III, the LPL was absent in 16 cases; ④ Type IV, the LPL was inserted at TPT in 6 cases; ⑤ Type V, the LPL was inserted at the intermediate cuneiform (IC) in 1 case; ⑥ Type VI, bifid LPL with one bundle inserted at the base of M2, and the other bundle inserted at the medial cuneiform (MC) in 4 cases; ⑦ Type VII, two bundles of LPL inserted at the base of M2 in 8 cases; ⑧ Type VIII, the LPL consisted of 3 bundles; the distal, middle and proximal bundles was inserted at the base of M2, the TPT and the lateral side of navicular bone in 2 cases, respectively. (2) There was a statistical significance in the length of LPL between male (31.62 ± 3.83) mm and female (28.07 ± 3.46) mm (t=-3.050, P = 0.003). There was no statistical significance in the types of LPL between male and female (Z=-1.721, P > 0.05), and no statistical significance in the types between left and right sides (Z=-0.026, P > 0.05).
According to our research, LPL originates from M5 and is divided into 8 types according to its insertion location, of which insertion at the base of M2 is the most common. In addition, we found that LPL has fibrous fusion with the long plantar ligament and the TPT, which may be involved in maintaining arch stability. The classification of LPL in this study is a supplement to the anatomical structure of the middle foot and Lisfranc joint complex, providing a new direction for the diagnosis and treatment of middle foot and arch injury in the future.
阐明山东省西南部人群中横跖弓（TMA）的足底外侧韧带（LPL）的解剖学特征，以补充中足和Lisfranc关节复合体的解剖结构。
共解剖100条成人下肢，并根据LPL的附着点对其类型进行划分，其中男性63例（63%），女性37例（37%）；左侧50例（50%），右侧50例（50%）。测量LPL的纤维束长度、起点宽度、附着点宽度和厚度。
（1）根据LPL的附着点，将其分为：①Ⅰ型，LPL附着于第二跖骨（M2）基部47例；②Ⅱ型，LPL附着于M2基部并与胫后肌腱（TPT）融合16例；③Ⅲ型，LPL缺如16例；④Ⅳ型，LPL附着于TPT 6例；⑤Ⅴ型，LPL附着于中间楔骨（IC）1例；⑥Ⅵ型，双叉LPL，一束附着于M2基部，另一束附着于内侧楔骨（MC）4例；⑦Ⅶ型，两束LPL附着于M2基部8例；⑧Ⅷ型，LPL由3束组成，远侧、中间和近侧束分别附着于M2基部、TPT和舟骨外侧2例。（2）男性（31.62±3.83）mm与女性（28.07±３.46）mm的LPL长度有统计学意义（t=-3.050，P=0.003）。LPL的类型在男性和女性之间无统计学意义（Z=-1.721，P＞0.05），左右侧之间的类型也无统计学意义（Z=-0.026，P＞0.05）。
根据我们的研究，LPL起于第五跖骨，根据其附着位置分为8种类型，其中附着于M2基部最为常见。此外，我们发现LPL与足底长韧带和TPT有纤维融合，可能参与维持足弓稳定性。本研究中LPL的分类是对中足和Lisfranc关节复合体解剖结构的补充，为未来中足和足弓损伤的诊断和治疗提供了新的方向。
