The transverse head of adductor hallucis originates from the plantar plate and deep transverse metatarsal ligament rather than the metatarsal shafts, providing transverse arch compression across all five metatarsal heads.
| Origin | Plantar MTP ligaments of the third, fourth, and fifth toes and the deep transverse metatarsal ligament |
|---|---|
| Insertion | Lateral base of the hallux proximal phalanx via the lateral sesamoid |
| Nerve Supply | Deep branch of lateral plantar nerve (S2, S3) |
| Blood Supply | Plantar metatarsal arteries |
| Actions | Adducts the hallux — transverse component; Supports the transverse metatarsal arch; Maintains metatarsal head alignment |
|---|
Transverse head contracture contributes to lesser toe MTP subluxation in rheumatoid forefoot deformity. Its release during forefoot arthroplasty is required for MTP joint correction. Metatarsalgia from transverse head spasm responds to targeted plantar injection.
Not directly palpable — accessed in the intermetatarsal spaces from the plantar surface.
Transverse head adductor hallucis contracture contributing to lesser MTP subluxation and hallux valgus in rheumatoid arthritis, addressed during forefoot reconstruction surgery.