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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Palmar Radial Extrinsic Wrist Ligament

- Discussion:
   - 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;
   - references:
          - The palmar radiocarpal ligaments: a study of adult and fetal human wrist joints
          - Osseous and Ligamentous Scaphoid Anatomy: Part I. A Systematic Literature Review Highlighting Controversies
   - 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.
           - Mechanism of Carpal Injuries.
           - Carpal Dislocations: pathomechanics and progressive perilunar instability.




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Sunday, March 24, 2013 3:37 pm