- Volar Wrist Ligaments:
- ligaments of wrist are most highly developed on palmar side of wrist;
- palmar wrist ligaments originate laterally from radial styloid, & are directed in a distal ulnar direction;
-
intrinsic ligaments:
- radial ligaments arise on palmar facet of radial styloid passing on to capitate;
- ulnar sided intrinsic ligaments:
- capitohamate ligaments:
- three distinct ligaments: dorsal, volar, and deep portions;
- lunotriquetral ligaments:
- c-shaped ligament with three parts: the dorsal, volar (most important), and intramembranous portions;
- between these arcades, is
space of Poirier;
- thru this interval escapes of distal carpal row from lunate in perilunar dislocation;
-
palmar ulnar extrinsic ligaments
- ulnotriquetral (medial)
- ulnolunate (medial)
- this is a key ligament along w/ the
TFC;
- on occassion, may avulse from its insertion on lunate, and this injury will allow dye extension both into
distal RU joint and into mid-carpal joint;
- ref:
An anatomical study of the ligaments of the ulnar compartment of the wrist
-
palmar radial extrinsic ligaments:
- short radiolunate ligament:
- arises from palmar fibers of TFCC,
originates from palmar margin of distal part of
radius and inserts into proximal part of palmar surface
of lunate;
-
long radiolunate ligament:
- parallel to radioscaphocapitate ligament, runs
from the palmar rim of the distal part of the radius to the
radial margin of palmar horn of lunate;
- radiolunate ligament (RLL): this goes on to pass from lunate to triquetrum as lunotriquetral ligament;
- radioscaphoid: inserts onto the tuberosity of scphoid & is radial expansion of radiocapitate ligament;
-
radioscapholunate: (ligament of Testut and Kuenz);
- orignates from palmar aspect of ridge between scaphoid & lunate fossae & inserts into scapholunate interosseous ligament;
- it acts as neurovascular supply to scapholunate interosseous membrane and is not a true extrinsic ligament of wrist;
- ref:
Radioscapholunate ligament: a gross anatomic and histologic study of fetal and adult wrists.
-
radioscaphocapitate:
- runs from volar aspect of radial styloid process, runs across scaphoid (through groove in its waist
), and inserts into palmar side of capitate;
- courses over palmar concavity of scaphoid proximal to tuberosity before inserting on palmar aspect of the keel and neck of the capitate;
- it forms a fulcrum over which the scaphoid rotates;
- radiocapitate ligament is the primary stabilizer of capitolunate joint, and is the primary stabilizer of the distal carpal row on proximal carpal row;
-
space of poirier:
- volar part of capsule of wrist has area of weakness, called
space of Poirier;
- located between the radioscaphocapitate
and long radiolunate ligaments, at the level of the midcarpal
joint;
- lies betweene main ligamentous structures that are attached proximally on lunate & distally on capitate;
- references:
-
The palmar wrist ligaments revisited, clinical relevance.
-
The palmar radiocarpal ligaments: A study of adult and fetal human wrist ligaments. RA Berger and JMF Landsmeer. J. Hand Surg. Vol 15. 1990. p 847-854.
- Mechanism of Carpal Injuries. Mayfield, JK. CORR. 149: 45-54. 1980.
- Carpal Dislocations: pathomechanics and progressive perilunar instability. Mayfield, JK, Johnson RP, and Kilcoyne, RK. J. Hand Surg. 5: 226-241, 1980.
- Dorsal Wrist Ligaments:
- superficial layer;
-
dorsal approach to the wrist: splits the dorsal radiotriquetral ligament proximally
and the dorsal intercarpal ligament distally;
- dorsal oblique radiotriquetral ligaments:
- dorsal transverse intercarpal (trapezoidal-triquetral ligament):
- this ligament has some fibers which insert on the dorsal ridge of scaphoid but none that insert on the distal pole of the scaphoid;
- major portion of the ligament inserts onto the trapezium;
- dorsal radiocarpal ligament:
- ref:
The Incidence of Dorsal Radiocarpal Ligament Tears in Patients Having Diagnostic Wrist Arthroscopy for Wrist Pain
- deep layer:
-
scapholunate interosseous ligament;
- lunotriquetal interosseous ligament;
- scaphocapitate and scaphotrapezium-trapezoid ligaments: attach to distal pole of the scaphoid and resists scaphoid flexion;
- references:
-
The dorsal ligaments of the wrist: anatomy, mechanical properties, and function. Viegas, S. F. J. Hand Surg., 24A: 456-468, 1999.
-
The dorsal ligaments of the wrist.
- Wrist Ligament Injuries: (see
carpal instability);
- most of tension injuries to wrist occur w/ wrist hyperextenion;
- radiocarpal ligaments will exceed their normal elastic limits w/ extreme hyperextension;
- injuries that result may be characterized as part of spectrum of injuries including
scapholunate dissociation and
perilunar dislocation;
- interosseous ligaments of distal row seldom fail clinically;
The Ligaments of the Wrist. Taleisnik J. J. Hand Surgery 1976; 1: 110-118.
Disruption of the ulnolunate ligament as a cause of chronic wrist pain. JF Mooney MD and GG Poehling MD The Journal of Hand Surgery. Vol. 16A, No 2. March 1991.
Wrist Ligamentous Anatomy and Pathogenesis of Carpal Instability. Mayfield JK. Orthop Clin North America. 1984; 15(2): 209-216.
The ligaments of the wrist: a current overview of anatomy with considerations of their potential functions. RA Berger. Hand Clin. Vol 13. 1997. p 6382.
