The Wrist Complex







1. Distal Radius

2. Distal Ulna

—Carpals—

3. Scaphoid

4. Lunate

5. Triquetrum

6. Pisiform

7. Trapezium

8. Trapezoid

9. Capitate

10. Hamate

”Sally Loves Tom’s Pie”

”Tom Takes Cake Home”

1 through 5 Metacarpals







Radiocarpal Joint

Biaxial condyloid joint — flexion/extension, radial/ulnar deviation



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The radial collateral ligament of the wrist joint forms a thickening of the articular capsule on the lateral side of the wrist joint. It arises from the radial styloid process and extends distally to insert onto the waist (or narrowing part) of the scaphoid.


The radial collateral ligament of the wrist joint strengthens the articular capsule of the radiocarpal joint and provides stability between the radius and the carpal bones.

The ulnar collateral ligament of the wrist joint forms a thickening of the articular capsule on the medial side of the wrist joint.

It arises from the ulnar styloid process and extends distally to insert onto the proximal surface of the triquetrum.

The ulnar collateral ligament of the wrist joint strengthens the articular capsule of the radiocarpal joint and provides stability between the radius and the carpal bones.


The palmar intercarpal ligaments are formed by several short fibrous bands that extend transversely across the palmar surface of the carpal bones. They serve to stabilize the carpal bones in the midcarpal joint and to allow limited movement (gliding) between them.















The palmar aponeurosis radiates into the fingers and covers the soft tissue and long flexor tendons of the hand. The median nerve and the superficial palmar arch travels deep to the aponeurosis to reach their targets, while the palmar cutaneous branch of the ulnar nerve travels above the palmar aponeurosis.

The flexor tendons pass through short channels formed between the palmar aponeurosis and the heads of the metacarpal bones. The palmar digital arteries and nerves pass between the four digital slips of the aponeurosis to reach the fingers.


The palmar aponeurosis is a strong, triangular membrane covering the tendons and muscles on the palmar surface of the hand. It is composed of longitudinal and transverse fibers.

The apex of the longitudinal fibers is continuous with palmaris longus, when present, or is anchored to the flexor retinaculum of the wrist. The fibers run distally producing four longitudinal bundles, which travel to the fingers. A less well-defined bundle passes to the thumb.


The longitudinal fibers divide into three layers distal to the transverse fibers of the palmar aponeurosis.


The superficial longitudinal fibers insert superficially into the skin of the distal palm and the base of the fingers. —The middle longitudinal fibers pass deep to the superficial transverse metacarpal ligament and into the fingers where they are continuous with the lateral digital sheaths.


The deepest layer of longitudinal fibers penetrate the deep traverse metacarpal ligament to pass around the sides of the metacarpophalangeal joint and attach to the metacarpal bone, proximal phalanx, and extensor tendon.


The transverse fibers are the deepest layer of the palmar fascia and lie proximal to the distal palmar crease. Its fibers blend with the anterior fibers of the flexor tendon sheaths. Vertical fibers connect the palmar aponeurosis to the thenar and hypothenar eminences.

The palmar aponeurosis acts as the insertion point for the tendon of palmaris longus and is the origin point for palmaris brevis. The transverse fibers support the webs between the fingers. As it attaches to the skin, it improves the grip of the hand and helps protect the under-lying tendons.