Intercarpal joints

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Intercarpal joints
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Vertical section through the joints at the wrist, showing the synovial cavities.
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Ligaments of wrist. Anterior view
Details
Identifiers
Latin articulationes intercarpeae
MeSH D050824
TA98 A03.5.11.101
TA2 1803
FMA 71361
Anatomical terminology

The intercarpal joints (joints of the carpal bones of the wrist ) can be subdivided into three sets of joints (also called articulations): Those of the proximal row of carpal bones, those of the distal row of carpal bones, and those of the two rows with each other.

Contents

Articulations

Joints of the hand, X-ray 814 Radiograph of Hand.jpg
Joints of the hand, X-ray

The bones in each carpal row interlock with each other and each row can therefore be considered a single joint. In the proximal row a limited degree of mobility is possible, but the bones of the distal row are connected to each other and to the metacarpal bones by strong ligaments that make this row and the metacarpus a functional entity. [1]

Proximal row

The joints of the proximal row are arthrodial joints, The scaphoid, lunate, and triquetrum are connected by dorsal, volar, and interosseous ligaments.

The dorsal intercarpal ligament are two in number and placed transversely behind the bones of the first row; they connect the scaphoid and lunate, and the lunate and triquetrum.

The palmar intercarpal ligaments are also two, connect the scaphoid and lunate, and the lunate and triangular; they are less strong than the dorsal, and placed very deeply behind the Flexor tendons and the volar radiocarpal ligament.

The interosseous intercarpal ligaments are two narrow bundles, one connecting the lunate with the scaphoid, the other joining it to the triangular. They are on a level with the superior surfaces of these bones, and their upper surfaces are smooth, and form part of the convex articular surface of the wrist-joint.

The ligaments connecting the pisiform bone are the articular capsule and the two volar ligaments. The articular capsule is a thin membrane which connects the pisiform to the triangular; it is lined by synovial membrane.

The two volar ligaments are strong fibrous bands; one, the pisohamate ligament, connects the pisiform to the hamate, the other, the pisometacarpal ligament, joins the pisiform to the base of the fifth metacarpal bone. These ligaments are, in reality, prolongations of the tendon of the Flexor carpi ulnaris.

Distal row

These joints are also arthrodial joints connected by dorsal, volar, and interosseous ligaments.

The dorsal ligaments are three in number, extend transversely from one bone to another on the dorsal surface, connecting the greater with the lesser multangular, the lesser multangular with the capitate, and the capitate with the hamate.

The volar ligaments are also three and have a similar arrangement on the volar surface.

The three interosseous ligaments are much thicker than those of the first row; one is placed between the capitate and the hamate, a second between the capitate and the lesser multangular, and a third between the greater and lesser multangulars. The first is much the strongest, and the third is sometimes wanting.

Midcarpal

See Midcarpal joint

Synovial membrane

The synovial membrane of the carpus is very extensive, and bounds a synovial cavity of very irregular shape.

The upper portion of the cavity intervenes between the under surfaces of the navicular, lunate, and triangular bones and the upper surfaces of the bones of the second row.

It sends two prolongations upward—between the navicular and lunate, and the lunate and triangular—and three prolongations downward between the four bones of the second row.

The prolongation between the greater and lesser multangulars, or that between the lesser multangular and capitate, is, owing to the absence of the interosseous ligament, often continuous with the cavity of the carpometacarpal joints, sometimes of the second, third, fourth, and fifth metacarpal bones, sometimes of the second and third only.

In the latter condition the joint between the hamate and the fourth and fifth metacarpal bones has a separate synovial membrane.

The synovial cavities of these joints are prolonged for a short distance between the bases of the metacarpal bones.

There is a separate synovial membrane between the pisiform and triangular.

Movements

The articulation of the hand and wrist considered as a whole involves four articular surfaces:

These four surfaces form two joints: (1) a proximal, the wrist-joint proper; and (2) a distal, the mid-carpal joint.

Mid-carpal joint

See Midcarpal joint

Notes

PD-icon.svgThis article incorporates text in the public domain from page 328 of the 20th edition of Gray's Anatomy (1918)

  1. Platzer 2004, p 130

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<span class="mw-page-title-main">Metacarpal bones</span> Bones of hand

In human anatomy, the metacarpal bones or metacarpus, also known as the "palm bones", are the appendicular bones that form the intermediate part of the hand between the phalanges (fingers) and the carpal bones, which articulate with the forearm. The metacarpal bones are homologous to the metatarsal bones in the foot.

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The scaphoid bone is one of the carpal bones of the wrist. It is situated between the hand and forearm on the thumb side of the wrist. It forms the radial border of the carpal tunnel. The scaphoid bone is the largest bone of the proximal row of wrist bones, its long axis being from above downward, lateralward, and forward. It is approximately the size and shape of a medium cashew nut.

<span class="mw-page-title-main">Capitate bone</span> Carpal bone in the wrist

The capitate bone is a bone in the human wrist found in the center of the carpal bone region, located at the distal end of the radius and ulna bones. It articulates with the third metacarpal bone and forms the third carpometacarpal joint. The capitate bone is the largest of the carpal bones in the human hand. It presents, above, a rounded portion or head, which is received into the concavity formed by the scaphoid and lunate bones; a constricted portion or neck; and below this, the body. The bone is also found in many other mammals, and is homologous with the "third distal carpal" of reptiles and amphibians.

<span class="mw-page-title-main">Hamate bone</span> Carpal bone in the wrist

The hamate bone, or unciform bone, Latin os hamatum and occasionally abbreviated as just hamatum, is a bone in the human wrist readily distinguishable by its wedge shape and a hook-like process ("hamulus") projecting from its palmar surface.

<span class="mw-page-title-main">Lunate bone</span> Carpal bone in the human hand

The lunate bone is a carpal bone in the human hand. It is distinguished by its deep concavity and crescentic outline. It is situated in the center of the proximal row carpal bones, which lie between the ulna and radius and the hand. The lunate carpal bone is situated between the lateral scaphoid bone and medial triquetral bone.

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<span class="mw-page-title-main">Carpometacarpal joint</span>

The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones.

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<span class="mw-page-title-main">Intermetatarsal joints</span>

The intermetatarsal joints are the articulations between the base of metatarsal bones.

<span class="mw-page-title-main">Triangular fibrocartilage</span> Anatomical feature in the wrist

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<span class="mw-page-title-main">Midcarpal joint</span>

The midcarpal joint is formed by the scaphoid, lunate, and triquetral bones in the proximal row, and the trapezium, trapezoid, capitate, and hamate bones in the distal row. The distal pole of the scaphoid articulates with two trapezial bones as a gliding type of joint. The proximal end of the scaphoid combines with the lunate and triquetrum to form a deep concavity that articulates with the convexity of the combined capitate and hamate in a form of diarthrodial, almost condyloid joint.

<span class="mw-page-title-main">Dorsal carpometacarpal ligaments</span> Ligaments in the hand

The dorsal carpometacarpal ligaments, the strongest and most distinct carpometacarpal ligaments, connect the carpal and metacarpal bones on their dorsal surfaces.

<span class="mw-page-title-main">Palmar carpometacarpal ligaments</span>

The Palmar carpometacarpal ligaments are a series of bands on the palmar surface of the carpometacarpal joints that connect the carpal bones to the second through fifth metacarpal bones. The second metacarpal is connected to the trapezium. The third metacarpal is connected to the trapezium, to the capitate, and to the hamate. The fourth and fifth metacarpals are connected to the hamate.

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Wrist osteoarthritis is gradual loss of articular cartilage and hypertrophic bone changes (osteophytes). While in many joints this is part of normal aging (senescence), in the wrist osteoarthritis usually occurs over years to decades after scapholunate interosseous ligament rupture or an unhealed fracture of the scaphoid. Characteristic symptoms including pain, deformity and stiffness. Pain intensity and incapability are notably variable and do not correspond with arthritis severity on radiographs.

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