The medial cuneiform is the largest of the three cuneiform bones, articulating with the navicular, intermediate cuneiform, and first metatarsal. It receives the insertion of the tibialis anterior and tibialis posterior tendons.
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| Ossification | Endochondral ossification from a single centre appearing at age 2. |
The medial cuneiform is the largest of the three cuneiforms and the insertion site of the tibialis anterior tendon on its plantar-medial surface. The Lisfranc ligament connects it to the second metatarsal base on its lateral surface, the keystone ligament of the Lisfranc joint complex whose disruption produces Lisfranc instability requiring surgical fixation.
Disruption of the Lisfranc ligament between the medial cuneiform and the base of the second metatarsal destabilises the midfoot and is easily missed.
An uncommon fracture from direct crush or as part of a tarsometatarsal injury.
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