Advanced Metatarsals Quiz

Q1. Why is the second metatarsal often described as a keystone of the Lisfranc region?

• Its shaft is fused to the cuboid
• Its head articulates directly with the talus
• It forms the lateral malleolus
• Its recessed base interlocks with the cuneiforms

Q2. Which ligament directly connects the medial cuneiform to the base of the second metatarsal?

• Spring ligament
• Calcaneofibular ligament
• Lisfranc ligament
• Anterior talofibular ligament

Q3. Why can widening between the first and second metatarsal region raise concern for a Lisfranc injury?

• It reflects only ankle instability
• It indicates an isolated Achilles rupture
• It is always a normal variant
• It can indicate instability of the tarsometatarsal complex

Q4. What distinguishes a classic Jones fracture from a simple avulsion fracture of the fifth metatarsal tuberosity?

• It is confined to the distal phalanx
• It occurs near the metaphyseal-diaphyseal junction distal to the tuberosity
• It is a fracture of the first metatarsal
• It occurs only at the fifth metatarsal head

Q5. Why can a Jones fracture have delayed healing or nonunion?

• The fracture occurs in a region with relatively vulnerable blood supply
• The fracture always lies inside a tendon
• The region is not subjected to mechanical load
• The fifth metatarsal has no blood vessels

Q6. What is a stress fracture pattern commonly associated with repetitive loading of the metatarsals?

• Acute fracture caused only by tendon avulsion
• Dislocation of the ankle mortise
• Fatigue fracture from repeated submaximal loading
• Congenital fusion of all metatarsals

Q7. How do the metatarsal heads contribute to the transverse arch of the forefoot?

• They articulate directly with the tibia
• They form part of the curved load-bearing forefoot
• They create the subtalar joint
• They form the posterior heel

Q8. Why is the first metatarsal important during push-off in gait?

• It transmits substantial load through the medial forefoot during propulsion
• It remains non-weight-bearing throughout gait
• It functions only as a tendon pulley without bearing load
• It forms the ankle mortise

Q9. Why can malalignment of a metatarsal fracture alter forefoot function even after union?

• Only the calcaneus contacts the ground
• Malalignment can redistribute load across the metatarsal heads
• Metatarsal alignment has no effect on loading
• The metatarsals do not participate in gait

Q10. Which statement best integrates the anatomy of the metatarsals?

• They are five sesamoids embedded in plantar tendons
• They are hindfoot bones that form the heel
• They form the structural forefoot link between the tarsus and toes and are central to stability, arch mechanics, and load transmission
• They articulate directly with the tibia to form the ankle