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Tarsus Anatomy

Dane Tatarniuk, DVM
Bones
•
•
•
•
•
•

Talus b.
Calcaneus b.
Central tarsal b.
1st & 2nd (fused) tarsal b.
3rd tarsal b.
4th tarsal b.

• Proximally: Tibia
• Distally: 2nd, 3rd, 4th metatarsal b.
Dorsal-Plantar

Lateral-medial
DLPMO

DMPLO
PMDLO

PLDMO
Plantar-Dorsal
Joints
• Tarsocrural
• Talocalcaneal
• Proximal Intertarsal
• Talocalcaneal-Centroquatral

• Distal Intertarsal
– Centrodistal

• Tarsometatarsal
Tarsocrural
• Ginglymus Joint
– Hinge-like joint, direction in only one plane
– Deep grooves in cochlear surface of distal tibia,
and trochlea of the talus

• Articulation
– 12 to 15 degrees to the sagittal plane, in dorsallateral direction
PIT / DIT / TMT
• Plane joints
• Only a very limited gliding movement
Joint Capsule
• Proximal: attaches to distal aspect of the tibia
• Distal: attaches to metatarsal bones
• Joint Pouch Effusion:
– Dorsal-medial aspect of joint capsule, at level of
medial trochlea
– Proximal aspect of plantar joint capsule, at level of
talus and distal tibia, both medial/lateral side
Ligaments
• Lateral Long Collateral Ligament
– Superficial
– Originate: Caudal aspect of lateral malleolus of
distal tibia
– Inserts: Fourth tarsal b., third metatarsal b., fourth
metatarsal b.
– Forms canal for lateral digital extensor tendon
Ligaments
• Lateral Short Collateral Ligament
– Deep to long collateral
– Originates: Cranial aspect of lateral malleolus of
the distal tibia
– Runs caudally
– Insertion: Lateral aspect of calcaneus
Ligaments
• Medial Long Collateral Ligament
– Originates: Caudal aspect of medial malleolus of
distal tibia
– Insertion: Second metatarsal b., third metatarsal
b., medial aspect third tarsal b.
Ligaments
• Medial Short Collateral Ligament
– Deep to medial long collateral
– Originates: Cranial aspect of the medial malleolus
of distal tibia
– Insertion: Medial aspect of the calcaneus and
sustentaculum tali
Ligaments
• Long Plantar Ligament
– Strong, flat band
– Originates: Proximal plantar aspect of calcaneus
– Insertion: Fourth metatarsal b., fourth tarsal b.
Ligaments
• Dorsal tarsal ligament
– Originates: Distal tuberosity of the talus
– Insertion: Central tarsal b., third tarsal b., proximal
third metatarsal b.
Muscle/Tendons
• Cranial-lateral
– Tibialis cranialis
•
•
•
•
•

Flexor of hock
Originates from lateral condyle of tibia
Tendon passes through split in peroneus tertius
Tibialis cranialis tendon then splits itself
Insertion:
– Dorsal branch, proximal third metatarsus
– Medial branch, crosses the medial long collateral ligament and
inserts on the fused 1st & 2nd tarsal bone

• Innervated by peroneal nerve
Muscle/Tendons
• Cranial-lateral
– Peroneus tertius
•
•
•
•

Originates from distal femur
Courses alongside the long extensor muscle
Bifurcates at the dorsal tarsus
Lateral branch inserts on calcaneous b. and fourth
tarsal b.
• Dorsal branch inserts on the proximal third metatarsal
• Links the flexion of hock and stifle
• Innervated by peroneal nerve
Muscle/Tendons
• Cranial-lateral
– Long digital extensor
• Originates from distal femur
• Inserts on the extensor process of third phalanx
• Lateral extensor tendon joins into long at level of
proximal metatarsus
• Tendon sheath present as it crosses the dorsal tarsus
• Held in place by 3 retinacula
• Synovial sheath present
• Flexes the hock, extends the digit
• Innervated by peroneal nerve
Muscle/Tendons
• Cranial-lateral
– Lateral digital extensor
•
•
•
•
•

Originates lateral collateral ligament of stifle
Inserts (joins) into the long extensor tendon
Held in place by retinaculum
Synovial sheath present
Innervated by peroneal nerve

– Extensor digitalis brevis
• Small, short digital extensor tendon between the angle of
the long and lateral digital extensor tendons
Muscle/Tendons
• Caudal
– Gastrocnemius
• Originates from 2 heads on the supracondylar
tuberosities of the femur, superficial to SDFT
• Inserts on the points of the calcaneus, deep to
superficial digital flexor tendon
• Extends the hock
• Innervated by tibial nerve
Muscle/Tendons
• Caudal
– Superficial digital flexor
• Originates from the supracondylar fossa of femur, deep
to gastrocnemius
• Twists medially to become superficial to gastrocnemius
• Medial and lateral aspects insert on the point of the
calcaneus
• Remainder of SDFT continues down plantar aspect of
distal limb, inserts on first and second phalanx
• Innervated by tibial nerve
Muscle/Tendons
• Caudal
– Deep digital flexor tendon
• Originates from three heads
– Lateral digital flexor & Tibialis caudalis
» Originates from caudal tibia
» Become joined, pass through the sustentaculum tali
» Tarsal sheath
– Medial digital flexor
» Originates from lateral condyle of tibia
» Passes within groove on medial malleolus and medial
collateral ligament

• Innervated by tibial nerve
Tendon Sheaths
• All the tendons
coursing over
the hock, with
exception of
superficial
digital flexor
tendon, have a
concurrent
tendon sheath
Bursas
• Cunean Bursa
– Directly deep to the
cunean tendon

• Calcaneal Bursa (2)
– Subcutaneous
– Subtendinous
Nerves & Vessels
Nerves & Vessels
References
•
•
•

Dr. Alexander zur Linden, http://vetmed.iastate.edu/limbanatomy/horse.html
Horowitz A., Berg R., “Anatomy of the Horse”, 5th ed.
Moyer, “Equine Joint Injection and Regional Anesthesia”, 3rd ed.

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Tarsal Anatomy of the Horse

  • 2. Bones • • • • • • Talus b. Calcaneus b. Central tarsal b. 1st & 2nd (fused) tarsal b. 3rd tarsal b. 4th tarsal b. • Proximally: Tibia • Distally: 2nd, 3rd, 4th metatarsal b.
  • 7. Joints • Tarsocrural • Talocalcaneal • Proximal Intertarsal • Talocalcaneal-Centroquatral • Distal Intertarsal – Centrodistal • Tarsometatarsal
  • 8. Tarsocrural • Ginglymus Joint – Hinge-like joint, direction in only one plane – Deep grooves in cochlear surface of distal tibia, and trochlea of the talus • Articulation – 12 to 15 degrees to the sagittal plane, in dorsallateral direction
  • 9. PIT / DIT / TMT • Plane joints • Only a very limited gliding movement
  • 10. Joint Capsule • Proximal: attaches to distal aspect of the tibia • Distal: attaches to metatarsal bones • Joint Pouch Effusion: – Dorsal-medial aspect of joint capsule, at level of medial trochlea – Proximal aspect of plantar joint capsule, at level of talus and distal tibia, both medial/lateral side
  • 11. Ligaments • Lateral Long Collateral Ligament – Superficial – Originate: Caudal aspect of lateral malleolus of distal tibia – Inserts: Fourth tarsal b., third metatarsal b., fourth metatarsal b. – Forms canal for lateral digital extensor tendon
  • 12. Ligaments • Lateral Short Collateral Ligament – Deep to long collateral – Originates: Cranial aspect of lateral malleolus of the distal tibia – Runs caudally – Insertion: Lateral aspect of calcaneus
  • 13. Ligaments • Medial Long Collateral Ligament – Originates: Caudal aspect of medial malleolus of distal tibia – Insertion: Second metatarsal b., third metatarsal b., medial aspect third tarsal b.
  • 14. Ligaments • Medial Short Collateral Ligament – Deep to medial long collateral – Originates: Cranial aspect of the medial malleolus of distal tibia – Insertion: Medial aspect of the calcaneus and sustentaculum tali
  • 15. Ligaments • Long Plantar Ligament – Strong, flat band – Originates: Proximal plantar aspect of calcaneus – Insertion: Fourth metatarsal b., fourth tarsal b.
  • 16. Ligaments • Dorsal tarsal ligament – Originates: Distal tuberosity of the talus – Insertion: Central tarsal b., third tarsal b., proximal third metatarsal b.
  • 17. Muscle/Tendons • Cranial-lateral – Tibialis cranialis • • • • • Flexor of hock Originates from lateral condyle of tibia Tendon passes through split in peroneus tertius Tibialis cranialis tendon then splits itself Insertion: – Dorsal branch, proximal third metatarsus – Medial branch, crosses the medial long collateral ligament and inserts on the fused 1st & 2nd tarsal bone • Innervated by peroneal nerve
  • 18. Muscle/Tendons • Cranial-lateral – Peroneus tertius • • • • Originates from distal femur Courses alongside the long extensor muscle Bifurcates at the dorsal tarsus Lateral branch inserts on calcaneous b. and fourth tarsal b. • Dorsal branch inserts on the proximal third metatarsal • Links the flexion of hock and stifle • Innervated by peroneal nerve
  • 19. Muscle/Tendons • Cranial-lateral – Long digital extensor • Originates from distal femur • Inserts on the extensor process of third phalanx • Lateral extensor tendon joins into long at level of proximal metatarsus • Tendon sheath present as it crosses the dorsal tarsus • Held in place by 3 retinacula • Synovial sheath present • Flexes the hock, extends the digit • Innervated by peroneal nerve
  • 20. Muscle/Tendons • Cranial-lateral – Lateral digital extensor • • • • • Originates lateral collateral ligament of stifle Inserts (joins) into the long extensor tendon Held in place by retinaculum Synovial sheath present Innervated by peroneal nerve – Extensor digitalis brevis • Small, short digital extensor tendon between the angle of the long and lateral digital extensor tendons
  • 21. Muscle/Tendons • Caudal – Gastrocnemius • Originates from 2 heads on the supracondylar tuberosities of the femur, superficial to SDFT • Inserts on the points of the calcaneus, deep to superficial digital flexor tendon • Extends the hock • Innervated by tibial nerve
  • 22. Muscle/Tendons • Caudal – Superficial digital flexor • Originates from the supracondylar fossa of femur, deep to gastrocnemius • Twists medially to become superficial to gastrocnemius • Medial and lateral aspects insert on the point of the calcaneus • Remainder of SDFT continues down plantar aspect of distal limb, inserts on first and second phalanx • Innervated by tibial nerve
  • 23. Muscle/Tendons • Caudal – Deep digital flexor tendon • Originates from three heads – Lateral digital flexor & Tibialis caudalis » Originates from caudal tibia » Become joined, pass through the sustentaculum tali » Tarsal sheath – Medial digital flexor » Originates from lateral condyle of tibia » Passes within groove on medial malleolus and medial collateral ligament • Innervated by tibial nerve
  • 24. Tendon Sheaths • All the tendons coursing over the hock, with exception of superficial digital flexor tendon, have a concurrent tendon sheath
  • 25. Bursas • Cunean Bursa – Directly deep to the cunean tendon • Calcaneal Bursa (2) – Subcutaneous – Subtendinous
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  • 33. References • • • Dr. Alexander zur Linden, http://vetmed.iastate.edu/limbanatomy/horse.html Horowitz A., Berg R., “Anatomy of the Horse”, 5th ed. Moyer, “Equine Joint Injection and Regional Anesthesia”, 3rd ed.