Joints and ligaments · Upper limb
Midcarpal ligaments !
The midcarpal ligaments link the eight wrist bones between and within their two rows, so the wrist moves as two coordinated rows.
Official name: Midcarpal and intercarpal ligaments
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What it is
Many short ligaments that tie the wrist bones to each other.
What it does
Make the eight wrist bones work as two coordinated rows.
Key facts
- Attaches
- Between the proximal and distal carpal rows (palmar arcuate ligament, dorsal intercarpal ligament) and between bones of each row
- Function
- Make the carpal rows move as linked units; midcarpal instability if lax
- Tight in
- Wrist extension (palmar ligaments); flexion (dorsal ligaments)
Relations
- Above
- Proximal carpal row: scaphoid, lunate and triquetrum
- Below
- Distal row and the bases of the metacarpals
- In front
- Floor of the carpal tunnel, with the flexor tendons and the median nerve under the flexor retinaculum
- Behind
- Dorsal intercarpal ligament and the extensor tendons
How to find it
Not palpable as single bands. On the front of the wrist the midcarpal joint lies roughly under the most distal of the wrist skin creases. On the back, the midcarpal arthroscopy portals sit about a finger-breadth distal to the radiocarpal portals, on either side of the capitate.
Examination
- Midcarpal shift test (Lichtman): with the forearm pronated, the examiner pushes the distal row palmarly at the capitate and moves the wrist into ulnar deviation; a painful clunk that reproduces the symptoms suggests palmar midcarpal instability
On imaging
The lateral view at rest may show a VISI pattern without a scapholunate or lunotriquetral gap. Dynamic fluoroscopy catches the sudden jump of the proximal row during ulnar deviation.
Clinical notes
- Midcarpal instability is often atraumatic in people with lax joints; normal intercarpal gaps set it apart from scapholunate and lunotriquetral tears
- Perilunate dislocation breaks the capitolunate connection (Mayfield stage II)
- Midcarpal arthroscopy portals inspect these ligaments and the scapholunate and lunotriquetral intervals from below
Test yourself
Think of the answer, then tap the question to see it.
What is the palmar arcuate ligament?
An inverted V of midcarpal ligaments from the scaphoid and triquetrum converging on the capitate.
What does laxity of the ulnar arm of the arcuate ligament cause?
Palmar midcarpal instability: a painful clunk as the proximal row snaps from flexion into extension in ulnar deviation.
What do the interosseous midcarpal ligaments of the distal row achieve?
They bind the trapezium, trapezoid, capitate and hamate into one rigid unit, while the proximal row moves as an intercalated segment.
Which test examines the midcarpal ligaments?
Lichtman's midcarpal shift test: forearm pronated, the distal row is pushed palmarly at the capitate while the wrist moves into ulnar deviation.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- ligamentum radiatum carpi TA2 1805
- Official Spanish (DeCS)
- Ligamento radiado del carpo; ligamentos intercarpianos palmares e interóseos
- English (TA2)
- Midcarpal and intercarpal ligaments
Related
Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Hand Carpal Bones; Anatomy, Shoulder and Upper Limb, Wrist Joint; Anatomy of the Human Body (20th ed.): Surface Anatomy of the Upper Extremity (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.
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Representative model, for educational purposes only.
