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Transverse Carpal Ligament

- Discussion:
    - transverse carpal ligament, is a heavy band of fibers which runs between hamate & pisiform medially to scaphoid and trapezium laterally, and forms fibrous sheath which contains carpal tunnel anteriorly within fibro-osseous tunnel;
    - posteriorly, tunnel is bordered by carpal bones, and transports median nerve & finger flexor tendons from forearm to hand;

- Landmarks:
    - distal volar flexion crease crosses proximal end of the scaphoid & pisiform & identifies proximal edge of the transverse carpal ligament;
    - pisiform is palpable and just laterally will identify entry of ulnar nerve and artery into hand;
    - all thenar & hypothenar muscles, except the abductor minimi, originate partly from the transverse carpal ligament.

    - Kaplan's Line:
           - Kaplan oblique line (line drawn from apex of interdigital fold between thumb and index finger, toward ulnar side of hand, parallel w/ proximal palmar crease, & passing 4-5 mm distal to pisiform bone

The transverse carpal ligament. An important component of the digital flexor pulley system.

Transverse carpal ligament reconstruction in surgery for carpal tunnel syndrome: a new technique [see comments].