Ligaments of Wrist and Hand

Question 1

Radiocarpal ligaments (NEED TO LOOK AT IMAGES)

Answer 1

Radial Collateral ligament (RCL)
- Radial styloid to scaphoid/ trapezium
- Resists ulnar deviation
Ulnar Collateral ligament (UCL)
- Ulnar styloid to triquetrum/pisiform
- Resists radial deviation
Palmar RC ligament (PRCL)
- Anterior radius to scaph/ lunate/triq 
- resists extreme wrist extension
Palmar Ulna Carpal ligament (PUCL)
- Anterior ulna to scaph/ lunate/triq
- resists extreme wrist extension
Dorsal RC ligament (DRCL)
- Posterior radius to scaph/ lunate/triq
- resists extreme wrist flexion

Question 2

Intercarpal ligament - scapholunate

Answer 2

• stability of the proximal carpal row important for wrist + hand function
• Scapholunate (interosseous) lig binds the scaphoid + lunate bones together
• is vulnerable to injury in falls onto the outstretched hand
• the result is an unstable wrist

Question 3

1st CMC joint ligaments

Answer 3

Radial CMC/ collateral lig
- Trapezium + 1st metacarpal
Anterior oblique lig
- Ant trapezium to medial 1st MC
- restricts thumb extension
Posterior oblique lig
- Post trapezium to medial 1st MC
- restricts thumb flexion

Question 4

MCP joint ligs

Answer 4

Collateral ligs
- medial/lateral joints stability
- tighter in flexion, looser in extension
Palmar lig (plate)
- Concave ligamentous/ fibrocartilaginous structure on palmar aspect of MCP joint
- prevents hyperextension, reinforces the joint capsule + increases the articular surface during extension
Deep transverse metacarpal
lig
- connects the palmar surface of the metacarpal heads (2-5) + holds the palmar plates
- stabilise metacarpal joints (maintain distal transverse arch)

Question 5

1st MCP (thumb) collateral ligs

Answer 5

• the UCL lig of the thumb is vulnerable
• excessive valgus stress to the base of the thumb may result in disruption of the ulnar collateral lig complex with or without an avulsion fracture of the base of the proximal phalanx (skier’s thumb)

Question 6

IP collateral ligs

Answer 6

• the posterior part of the collateral lig tightens as the IP joints move into flexion (so restrict this)
• and the anterior parts tighten as moving into extension
• these ligs also limit IP abd/add + twisting movts as these joints