Intermediate Cuneiform, Inferior View

Description

Seen from the plantar (inferior) aspect, the intermediate cuneiform (os cuneiforme intermedium) sits in the medial midfoot between the medial cuneiform and lateral cuneiform, just distal to the navicular and proximal to the base of the second metatarsal. Its wedge shape narrows toward the sole, and the inferior surface reads as a compact, roughly rectangular footprint compared with the broader dorsal surface. Medially and laterally, the nonarticular areas give purchase to the plantar cuneonavicular and intercuneiform ligaments, with the plantar tarsometatarsal bands spanning distally toward the second ray. That plantar view matters because the intermediate cuneiform acts as a keystone for the second tarsometatarsal joint, where the base of the second metatarsal is recessed between the cuneiforms and stabilised by the Lisfranc ligament complex. Subtle malalignment or plantar gapping at this level is a common miss in midfoot trauma, and it changes operative planning for suspected Lisfranc injuries, including decisions about open reduction and internal fixation versus primary arthrodesis. Small surfaces, tight tolerances. This is where instability hides. Use this illustration in gross anatomy and lower limb musculoskeletal courses to teach tarsal orientation and the architecture of the transverse and medial longitudinal arches, or in radiology and orthopaedic teaching files when correlating plantar bony landmarks with AP, oblique, and weight-bearing midfoot films and CT. It also suits surgical atlases covering midfoot approaches and fixation trajectories across the intercuneiform and tarsometatarsal joints. Anatomical accuracy verified by SciePro's Medical Advisory Board.