Summary
Variable wrist ligament descriptions and nomenclatures have been presented, but the dimensions of these ligaments have not yet been extensively investigated. To verify the numerous concepts advanced and to provide a better understanding of individual variations in carpal biomechanics, and the numerous pathomechanical concepts reported in the literature, this study aimed to determine capsular carpal ligament anatomy, their dimensions and variations. The origin, insertion, and number of fascicles of the capsular wrist ligaments were observed in precise dissection of 66 anatomic preparations. The dimensions of several capsular wrist ligaments were measured using a calliper : the parameters analysed being length and width at three levels each, from which mean length and width and approximate mean surface (product of mean length by mean width) were determined. The anatomy of the capsular ligaments of the wrist showed, besides relatively constant structures, considerable individual variations, particularly of the ulnocarpal and dorsal ligaments. The standard deviations of ligament lengths and widths were mostly less than 20% of the average value. Some measurements, however, showed larger variations, such as those associated with the dorsal scaphotriquetral and ulnocarpal ligaments. Ligament widths generally showed larger variations and less interdependency than did ligament lengths. The capsular wrist ligaments display morphologic and morphometric variations, which could explain the biomechanical variations reported in the literature, and the diversity of classifications and treatment methods proposed for carpal instability. Further studies, however, are needed to confirm this hypothesis.
Résumé
Des descriptions et nomenclatures variables des ligaments du poignet ont été présentées. Les dimensions de ces ligaments n'ont pas encore été étudiées en détail. Afin de vérifier les multiples concepts avancés et de fournir une meilleure compréhension des variations individuelles de la biomécanique carpienne, et des nombreux concepts pathomécaniques trouvés dans la littérature, cette étude a tenté de rapporter l'anatomie, les dimensions et variations des ligaments capsulaires carpiens. La dissection précise de 66 préparations anatomiques a permis l'observation de l'origine, de l'insertion, et du nombre de faisceaux des ligaments capsulaires du poignet. Les dimensions de plusieurs ligaments capsulaires du poignet ont été mesurées à l'aide d'un pied-à-coulisse. Les paramètres analysés étaient la longueur et la largeur à trois niveaux chacune, la longueur et la largeur moyenne et la surface moyenne approximative (produit de la longueur moyenne par la largeur moyenne). L'anatomie des ligaments capsulaires du poignet présentait, outre des structures relativement constantes, des variations individuelles considérables, particulièrement des ligaments ulno-carpiens et dorsaux. Les écarts-type des longueurs et largeurs ligamentaires étaient le plus souvent inférieurs à 20 % de la valeur moyenne. Certaines mesures, cependant, présentaient des variations plus importantes, tel que les ligaments scapho-triquetral dorsal et ulno-carpiens. Les largeurs présentaient en général des variations plus grandes et une moindre interdépendance que les longueurs. Les ligaments capsulaires du poignet présentent des variations morphologiques et morphométriques, qui pourraient expliquer les variations biomécaniques rapportées dans la littérature, et la diversité des classifications et méthodes de traitement proposées pour l'instabilité carpienne, bien que des études complémentaires soient nécessaires pour confirmer cette hypothèse.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Berger RA, Amadio PC (1994) Predicting palmar radiocarpal ligament disruption in fractures of the distal articular surface of the radius involving the palmar cortex. J Hand Surg 19B: 108–113
Berger RA, Landsmeer JMF (1990) The palmar radiocarpal ligaments: a study of adult and fetal human wrist joints. J Hand Surg 15A: 847–854
Craighen MAC, Stanley JK (1995) Wrist kinematics: row, column or both? J Hand Surg 20B: 165–170
De Lange A, Huiskes R, Kauer JMG (1990) Wrist-joint ligament length changes in flexion and deviation of the hand: an experimental study. J Orthop Res 8: 722–730
Efremov S, Oberlin C (1996) The pisiformtriquetral complex: an anatomical study. J Hand Surg 21B (suppl I): 20
Feipel V, Rooze M (1997) The capsular ligaments of the wrist. Eur J Morphol 35: 87–94
Feipel V, Rooze M, Louryan S, Lemort M (1992) Bi-and three-dimensional CT study of carpal bone motion in lateral deviation. Surg Radiol Anat 14: 381–389
Feipel V, Rooze M, Louryan S, Lemort M (1994) Functional anatomy of the carpus in radio-ulnar deviation and in flexion and extension: a bi- and three-dimensional CT study. In: Advances in the Biomechanics of the Hand and Wrist (F Schuind eds) NATO ASI Series Vol. A 256, Plenum Press, New York
Fick R (1904) Handbuch der Anatomie und Mechanik der Gelenke. Fischer-Verlag, Jena
Fisk GR (1970) Carpal instability and the fractured scaphoid. Ann R Coll Surg Engl 46: 63–76
Fisk GR (1984) The wrist. J Bone Joint Surg 66B: 396–407
Gilula LA, Weeks PM (1978) Post-traumatic ligamentous instabilities of the wrist. Radiology 129: 641–651
Green DP, O'Brien ET (1980) Classification and management of carpal dislocations. Clin Orthop 149: 55–72
Hogikyan JV, Louis DS (1992) Embryologic development and variations in the anatomy of the ulnocarpal ligamentous complex. J Hand Surg 17A: 719–723
Hurkmans HLP, Kooloos JGM, Meijer RS (1996) Scapho-lunate dissociation and arthrodesis. An experimental study with lesions of the interosseoux ligament and fusions with K-wires. Clin. Biomech 11: 220–226
Kauer JMG, Savelberg HHCM, Huiskes R, Kooloos JGM (1994) Role of the wrist ligaments with respect to carpal kinematics and carpal mechanism. In: Advances in the biomechanics of the hand and wrist (Schuind et al.) NATO ASI Series Vol. A 256, Plenum Press, New York
Kim HK, Ryu J, Han JS, Yang SB, Kish V (1994) A new cross-sectional area measurement technique for intrinsic and extrinsic human wrist ligaments: in-situ MRI study. Proceedings of the SIROT Inter-Meeting, Boston
Kooloos JGM, Savelberg HHCM (1992) Measurements of cross-sectional areas in selected human wrist-joint ligaments. Acta Anat 144: 325–328
Kuhlmann JN, Laudet C, Luboinski A, Boabighi A, Landjerit B, Guerin-Surville H, Baux S (1988) Les structures fibreuses du poignet. II — Etude biomécanique. Bull Assoc Anat 72: 31–35
Lewis OJ, Hamshere RJ, Bucknill TM (1970) The anatomy of the wrist joint. J Anat 106: 539–552
Linscheid RL (1986) Kinematic considerations of the wrist. Clin Orthop 202: 27–39
Linscheid RL, Dobyns JH, Beabout JW, Bryan RS (1972) Traumatic instability of the wrist: diagnosis, classifiation and pathomechanics. J Bone Joint Surg 54A: 1612–1632
Mayfield JK (1984) Patterns of injury to carpal ligaments. Clin Orthop 187: 36–42
Mayfield JK, Johnson RP, Kilcoyne RF (1976) The ligaments of the wrist and their functional significance. Anat Rec 186: 417–428
Mayfield JK, Williams WJ, Erdman AG, Dahlof WJ, Wallrich MA, Kleinhenz WA, Moody NR (1979) Biomechanical properties of human carpal ligaments. Orthop Trans 3: 143–144
Mizuseki T, Ikuta Y (1989) The dorsal carpal ligaments: their anatomy and function. J Hand Surg 14B: 91–98
Nowak MD, Logan SE (1991) Distinguishing biomechanical properties of intrinsic and extrinsic human wrist ligaments. J Biomech Eng 113: 85–93
Salvia P, Klein P, David JH, Rooze M (1994) The envelope of active wrist circumduction: an in vivo electrogoniometric study. In: Advances in the Biomechanics of the Hand and Wrist (F Schuind et al., eds) NATO ASI Series Vol. A 256, Plenum Press, New York
Savelberg HHCM, Otten JDM, Kooloos JGM, Huiskes R, Kauer JMG (1993) Carpal bone kinematics and ligament lengthening for the full range of joint movement. J Biomech 26: 1389–1404
Sennwald G, Segmüller G (1986) Base anatomique d'un nouveau concept de stabilité du carpe. Int Orthop 10: 25–30
Sennwald G, Zdravkovic V, Oberlin C (1994) The anatomy of the palmar scaphotriquetral ligament. J Bone Joint Surg 76B: 147–149
Smith DK (1993) Dorsal carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. Am J Roentgenol 161: 119–125
Smith DK (1993) Volar carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. Am J Roentgenol 161: 353–357
Taleisnik J (1976) The ligaments of the wrist. J Hand Surg 1: 110–118
Taleisnik J (1980) Post-traumatic carpal instability. Clin Orthop 149: 73–82
Van Sint Jan S, Rooze M (1992) The thenar muscles. New findings. Surg Radiol Anat 14: 325–329
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Feipel, V., Rooze, M. The capsular ligaments of the wrist: morphology, morphometry and clinical applications. Surg Radiol Anat 21, 175–180 (1999). https://doi.org/10.1007/BF01630897
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01630897