[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/) › Lunotriquetral ligament [Joints and ligaments](https://durgical.com/en/anatomy/system/joints-and-ligaments/) · [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/) # Lunotriquetral ligament The lunotriquetral ligament joins the lunate and triquetrum in the wrist's first row, so they move as one unit. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=upper_limb&select=lunotriquetral_lig&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A ligament joining the lunate and the triquetrum. ## What it does Keeps the lunate and triquetrum moving as a unit. ## Key points - Ties the triquetrum, which tends to extend, to the [lunate](https://durgical.com/en/anatomy/lunate/); when it tears, the lunate follows the [scaphoid](https://durgical.com/en/anatomy/scaphoid/) into flexion - Isolated tears often leave normal X-rays; a static VISI deformity (lunate flexed) appears only when the dorsal radiocarpal ligament fails as well - Third stage of a perilunate injury (Mayfield III), after the scapholunate tear and the capitolunate disruption ## Key facts **Attaches** Lunate to triquetrum (palmar strongest) **Function** Links the lunate and triquetrum **Tight in** Radial deviation / pronation loading ## Relations **Above** [TFCC](https://durgical.com/en/anatomy/triangular-fibrocartilage-complex/) and the [ulnocarpal ligaments](https://durgical.com/en/anatomy/ulnocarpal-ligaments/), with the ulnar head beyond them **Below** [Hamate](https://durgical.com/en/anatomy/hamate/) and the ulnar side of the [capitate](https://durgical.com/en/anatomy/capitate/), across the midcarpal joint **In front** Ulnolunate and ulnotriquetral ligaments and the ulnar arm of the palmar arcuate ligament **Behind** [Dorsal radiocarpal ligament](https://durgical.com/en/anatomy/dorsal-radiocarpal-ligament/) and [dorsal intercarpal ligament](https://durgical.com/en/anatomy/dorsal-intercarpal-ligament/), both attached to the [triquetrum](https://durgical.com/en/anatomy/triquetrum/) ## How to find it The LT interval is felt on the back of the wrist just distal to the ulnar head, between the lunate and the triquetrum; it is tender when pressed in LT injuries and is where the ballottement and shear tests are applied. ## Examination - Lunotriquetral ballottement (Reagan): the lunate is fixed between thumb and index of one hand while the triquetrum and [pisiform](https://durgical.com/en/anatomy/pisiform/) are pushed dorsally and palmarly with the other; pain, crepitus or excess movement suggests an LT tear - Shear test (Kleinman): the lunate is supported dorsally while the pisiform is pressed dorsally, shearing the joint; pain suggests an LT injury - LT compression test: pressure on the triquetrum from the ulnar side, just distal to the ulnar styloid, reproduces pain from the LT joint ## On imaging PA view: a step in the first carpal arc (Gilula) between lunate and triquetrum; a visible gap is rare. Lateral view: VISI, with the lunate flexed and a scapholunate angle below about 30°. Wrist arthrography shows contrast passing between the two bones; MR arthrography or arthroscopy confirms the tear. ## Clinical notes - Ulnar impaction can wear through the TFCC disc and then this ligament (Palmer degenerative stages 2D–2E) - Typical mechanism: a fall on the outstretched hand with the wrist extended and radially deviated, landing on the hypothenar side - Part of the differential of ulnar-sided wrist pain, with TFCC tears and ECU tendon problems ## Anatomical variants - Lunotriquetral coalition, the commonest carpal coalition, replaces the joint with bone or fibrous tissue; usually found by chance ## Development Carpal coalitions come from incomplete separation of the cartilage precursors of neighbouring carpal bones in the embryo. ## Test yourself Think of the answer, then tap the question to see it. ## What happens to the lunate when the lunotriquetral ligament tears? The lunate follows the scaphoid into flexion, no longer tied to the triquetrum, which tends to extend. ## When does a static VISI deformity appear with a lunotriquetral ligament tear? Only when the dorsal radiocarpal ligament fails as well; isolated tears often leave normal X-rays. ## Which ballottement test examines the lunotriquetral ligament? Reagan's test: the lunate is fixed between thumb and index while the triquetrum and pisiform are pushed dorsally and palmarly; pain or play is positive. ## Which stage of a perilunate injury tears the lunotriquetral ligament? Mayfield stage III, after the scapholunate tear and the capitolunate disruption. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/lunotriquetral-ligament/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** ligamentum lunotriquetrum interosseum TA2 1823 **Official Spanish (DeCS)** Ligamentos semilunopiramidales interóseo y palmar **English (TA2)** Lunotriquetral ligament **Also called** LT ligament ## Related - [TFCC](https://durgical.com/en/anatomy/triangular-fibrocartilage-complex/) - [Scapholunate ligament](https://durgical.com/en/anatomy/scapholunate-interosseous-ligament/) - [Hamate](https://durgical.com/en/anatomy/hamate/) - [Lunate](https://durgical.com/en/anatomy/lunate/) - [Triquetrum](https://durgical.com/en/anatomy/triquetrum/) Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Hand Carpal Bones](https://www.ncbi.nlm.nih.gov/books/NBK535382/); [Anatomy, Shoulder and Upper Limb, Wrist Joint](https://www.ncbi.nlm.nih.gov/books/NBK534779/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/lunotriquetral-ligament/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/lunotriquetral-ligament/