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Wrist Instability

2 carpal rows:

1. Distal

  • Trapezium, trapezoid, capitate, hamate bound together by strong interosseous (intrinsic) ligaments to form distal row, which moves together as a single unit

    2. Proximal

    • Scaphoid, lunate and triquetrum form the proximal row. It has no muscle attachments and is inherently unstable in compression without its ligamentous attachments. Acts as a link between the relatively rigid distal row and the radioulnar articulations.
  • Scaphoid, lunate and triquetrum form the proximal row. It has no muscle attachments and is inherently unstable in compression without its ligamentous attachments. Acts as a link between the relatively rigid distal row and the radioulnar articulations.

    Intrinsic ligaments

    • These have their origin and insertion within the same carpal row
    • Distal row
      • To bind all the distal carpal bones together
    • Proximal row
      • Scapholunate ligament
      • Lunotriquetral ligament
    • Distal row
      • To bind all the distal carpal bones together
    • Proximal row
      • Scapholunate ligament
      • Lunotriquetral ligament
    • Proximal row
      • Scapholunate ligament
      • Lunotriquetral ligament

    Extrinsic ligaments

    Volar

    • Stronger, and arranged in 2 distinct "V" shapes centred on the lunate and the capitate
    • The radioscapholunate ligament is now known to be a vascular pedicle rather than a true ligament
  • Stronger, and arranged in 2 distinct "V" shapes centred on the lunate and the capitate
  • The radioscapholunate ligament is now known to be a vascular pedicle rather than a true ligament


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