Talocalcaneonavicular Joint (TCN)

• TCN joint name ties together talonavicular

and talocalcaneal (subtalar) joints that are
anatomically and functionally related
• Talonavicular articulation is formed
proximally by the anterior portion of the
head of the talus and distally by concave
posterior navicular
Ligaments:
b. Spring ligament (plantar calcaneo
navicular ligament) (11)
c. Deltoid ligament

d. Bifurcate ligament (lateral calcaneo

navicular ligament) (15)
Joint function:
• Talus acts as a ball bearing placed
between the tibiofibular mortise
superiorly, calcaneum inferiorly and
navicle anteriorly
• Motion of the weight bearing talus at one
end will produce motion at other end
• Forces transmitted through the leg to the
talus are shared by each of the articular
surfaces that make up the TCN
• TCN joint is key to foot function
Transverse Tarsal Joint / mid tarsal joint:
• Compound joint formed by talonavicular and
calcaneocuboid joint
• Because the talonavicular joint is classically
considered to be a part of transverse tarsal
joint, it belongs to two joint complexes- TCN
joint and the transverse tarsal joint
• Other component of transverse tarsal joint is
calcaneocuboid joint
• Two joints together present an S shaped joint
line that transects the foot horizontally
dividing the hind foot from midfoot and
forefoot
• Navicular and cuboid are essentially
immobile in the weight bearing foot
• Transverse tarsal joint motion therefore, is
considered to be the motion of the talus and
of the calcaneum on a relatively fixed
naviculocuboid unit
Joint Structure:
• Talonavicular articulation is formed
proximally by the anterior portion of the head
of the talus and distally by concave posterior
navicular
• Calcaneocuboid joint is formed proximally
by the anterior calcaneus and distally by
posterior cuboid
Action :
• Transverse joint is transitional link
between the hind foot and the fore foot
serving
iii. To add supination and pronation range to
the TCN joint
iv. To compensate the fore foot and hindfoot
position
• Compensation refers to the ability of the
forefoot to remain flat on the ground
while the hindfoot is in varus or valgus
Tarsometatarsal joints :
• Plane synovial joints formed by cuboid and
three cuneiform bones and the bases of five
metatarsals
• Ist TMT: Base of Ist metatarsal & medial
cuneiform
• IInd TMT : Base of

IInd metatarsal &

middle cuneiform
with sides of medial
and lateral cuneiform
• IIIrd TMT: Base of IIIrd metatarsal & lateral
cuneiform
• IVth & Vth TMT : Base of IVth, Vth
metatarsal & cuboid
• There are also articulations between bases of
metatarsals so that motion at one permits
motion of another
Joint Function:
• These joints attempt to regulate the position
of the metatarsals and phalanges relative to
the weight-bearing surface
• When the position of hindfoot is extreme
and the transverse tarsal joint is inadequate
to provide compensation the TMT joints
rotate to provide further adjustment of fore
foot
Metatarsophalangeal Joint:
• Condyloid synovial joint with 2° freedom –
Flexion/Extension, Abduction/Adduction
• ‘Index Minus Foot’- 56% people have 2nd
metatarsal the longest followed by the 1st,
through the 3rd to 5th
• ‘Index plus minus foot’ - 28% people have
1st-2nd are of equal length
• ‘Index plus foot’- 16% people have 2nd
metatarsal smaller than the 1st
• The Ist MTP has two sesamoid bones which
help to increase the lever arm of FHB,
protects the FHL against the weight bearing
trauma
• The heads of the metatarsal bear weight in
stance phase
Joint Function:
• The MTP joints serve primarily to allow the
foot to “hinge” at the toes so that the heel
may rise off the ground while still
maintaining the small but dynamic base of
support afforded by the toes and the toe
musculature
 Metatarsal Break:
• Refers to single oblique axis that lies through the
second to the fifth metatarsal heads
• Metatarsal break may range from 54° to 73°
compared to the long axis of the foot
• From weight bearing heel to rise there will be an
active contraction of plantar flexors
• The musculature cannot normally lift the body
weight unless the joints of the hindfoot and mid
foot are fully supinated and locked
• That is the heel will rise when the foot has
become a rigid lever from the calcaneus through
the metatarsals
• The rigid lever will rotate around the
metatarsal break –MTP axis
• LOG moves forward but lies within the
BOS to maintain stability
• The obliquity of the axis helps in evenly
distributing the weight across the toes. With
a coronal axis excessive pressure would be
laid on the 1st and 2nd metatarsals
• ‘Hallux Valgus’- first toe is normally
adducted on the first metatarsal about 15°,
an increase in this angle
Inter phalengeal Joints (IP)
• Synovial Hinge Joints

• 1° of freedom – flexion/extension

• Function to smooth the weight shift to the

opposite foot in gait and help maintain the
stability by pressing against the ground both
in static posture and in gait
Plantar Arches:
• The bony and ligamentous configuration of the
TCN joint, the transverse tarsal joint, and the
TMT joints combine to produce a structural vault
with in the foot
• Shape and arrangement of bones are particularly
responsible for stability of plantar arches
• 2 different arches
5. Longitutional arch:
• Based posteriorly at the calcaneum and anteriorly
at the metatarsal heads
• Medial and lateral
• The medial side is the side for reference
1. Transverse arch:
• Visualized at the level of the anterior
tarsals and at the bases of metatarsals
• Middle cuneiform is the keystone of the
arch
 Function:
• The arches are adapted exclusively to serve weight
bearing functions of the foot
Stability functions:
• The following stability functions could be
performed by a foot with a fixed arch structure.
e. Distribution of weight through the foot for proper
weight bearing
f. Conversion of foot to a rigid lever
• Distribution of body weight depends on the shape
of the arch and location of LOG
• It begins at the talus
• In bilateral stance the talus receives 50% of body
weight and in unilateral stance it is 100%
• 50% of the weight received by the talus is divided
into subtalar and TCN and calcaneocuboid
articulations
• Because of the medial location of the talus the
medial side bears more weight than the lateral
• Similarly in bilateral stance distribution of weight
across the MT heads occurs in a 2:1:1:1:1 ratio
from 1st-5th ray
Mobility functions:
f. Dampening the shock of weight bearing
g. Adapting to changes in supporting surface
h. Dampening super imposed rotations
• Pes Planus – flat foot
• Pes cavus – high arch