Purpose
The distinction between the dorsal intercarpal (DIC) and dorsal scaphotriquetral (DST)
ligaments is imprecise and unclear in the literature. The purpose of our cadaveric
study was to define the origins, insertions, and anatomic relationships of the dorsal
wrist ligaments and relate these anatomic findings to magnetic resonance imaging (MRI)
scans and histology.
Methods
The study included 17 unmatched fresh-frozen cadaveric specimens (7 male and 10 female),
with a mean age of 67.1 years (range, 48–86 years). Wrists with arthritis or carpal
malalignment were excluded. Ligaments were dissected and insertion sites were recorded
in the radioulnar (width) and proximodistal (length) dimensions, centered at the midpoints
of the insertion. Three cadaveric specimens underwent a histologic analysis to demonstrate
ligament composition and insertion sites. Three additional cadavers underwent MRI,
from which 3-dimensional models were built to model ligament topography.
Results
The conjoined triquetral insertion of the DIC, DST, and dorsal radiocarpal (DRC) measured
88.5 ± 6.4 mm2. In each specimen, there were 2 distinct deep and superficial components of intercarpal
fibers. The deep component inserted on the lunate with an area of 59.0 ± 5.0 mm2. The deep and superficial components diverged as they coursed radially. The superficial
component proceeded to the scaphoid ridge, trapezium, and trapezoid, whereas the deep
component inserted on the proximal row. The deep fibers blended distally from their
lunate insertion with the DST, forming a robust, 2.9 ± 0.8-mm wide extension over
the dorsal capitate. The DRC inserted on the lunate, proximal to the DIC and DST insertions,
with an area of 23.9 ± 5.4 mm2.
Conclusions
The dorsal ligament complex forms a firm link across the proximal carpal row and the
DST provides extension of the proximal row over the capitate.
Clinical relevance
This information can guide surgeons while performing a dorsal approach to the wrist
and repairing traumatic ligament disruption.
Key words
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Article info
Publication history
Published online: July 19, 2021
Accepted:
June 2,
2021
Received:
July 30,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
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