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Second Tarsometatarsal Ligament

ligamentum tarsometatarsale secundum

The second tarsometatarsal ligament connects the second metatarsal base to the middle cuneiform, forming the most stable of the TMT joints. The deep (interosseous) Lisfranc ligament from the medial cuneiform to the second metatarsal is the primary Lisfranc ligament, but the second TMT has additional dorsal, plantar, and lateral capsular reinforcements.

Region: Foot & Ankle

Biomechanics

Function & Actions

Provides the primary stability of the second TMT joint — the most rigid of the five TMT joints, acting as the keystone of the midfoot transverse arch. The tight fit of the second metatarsal base into its cuneiform recess provides additional osseous constraint.

Clinical Relevance

Clinical Notes

The second TMT joint is the most commonly injured and most important joint to reduce anatomically in Lisfranc injuries. Its rigid constraint makes it the reference joint in Lisfranc reduction — accurate second metatarsal-middle cuneiform alignment is confirmed radiographically before other joints are addressed.

Pathology

Common Injuries & Conditions

Second TMT Joint Instability in Lisfranc Injury

Second TMT ligament disruption producing the primary instability in Lisfranc injuries — accurate reduction and fixation of this joint is the cornerstone of Lisfranc ORIF.