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The Journal of Bone and Joint Surgery 82:578 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Carpal Instability*{dagger}

Richard H. Gelberman, M.D.{ddagger}, William P. Cooney, III, M.D.§ and Robert M. Szabo, M.D, M.P.H.#

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
{dagger}Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2001 in Instructional Course Lectures, Volume 50. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
{ddagger}Department of Orthopaedic Surgery, Barnes-Jewish Hospital at Washington University, One Barnes Plaza, Suite 11300, St. Louis, Missouri 63110. E-mail address: gelbermanr@msnotes.wustl.edu.
§Department of Orthopaedic Surgery, Mayo Graduate School of Medicine, 1085 Orchard Acres Lane S.W., Rochester, Minnesota 55902. E-mail address: cooney.william@mayo.edu.
#Division of Plastic Surgery, Department of Surgery, University of California, Davis, School of Medicine, 4860 Y Street, Sacramento, California 95817. E-mail address: rmszabo@ucdavis.edu.


   Anatomy
 
The intracapsular ligaments of the wrist are divided into intrinsic and extrinsic components1-9. The two most important intrinsic (interosseous) ligaments, the scapholunate and lunotriquetral ligaments, are divided into dorsal, proximal, and palmar regions (Fig. 1)1,10. The thickest and strongest region of the scapholunate ligament is located dorsally10, and that of the lunotriquetral ligament is located palmarly10.



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  		Fig. 1: Illustration demonstrating the scapholunate and lunotriquetral interosseous ligaments (arrows). S = scaphoid, L = lunate, and T = triquetrum. (Reproduced, with modification, from: Berger, R. A.: The gross and histologic anatomy of the scapholunate interosseous ligament. J. Hand Surg., 21A: 172, 1996. Reprinted with permission.)

 
There are three strong palmar extrinsic radiocarpal ligaments: the radioscaphocapitate, long radiolunate, and short radiolunate ligaments2. The radioscaphocapitate ligament, which extends from the radial styloid process through a groove in the waist of the scaphoid to the palmar aspect of the capitate, . . . [Full Text of this Article]


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