The Articular Disc of the Wrist. Limits and Relations

García-Elias, Marc; Domènech-Mateu, J. M.

doi:10.1159/000146314

Cited by 33 publications

(23 citation statements)

References 5 publications

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“…1). The following six regions of the TFCC was clearly identified: (i) the fibrocartilaginous ADP; (ii) the MH, a fibrocartilage covered by the synovial membrane on its distal surface, emerging from the distal ulnar end of the ADP and running distally toward the joint capsule and carpal bones; (iii) a strong fibrous strand of the RUL attached to the proximal side of the ADP and running toward the ulnar fovea and the base of the ulnar styloid; (iv) the loose part of the UCL (lUCL) consisting of relatively loose connective tissue, which corresponds to the relatively loose ligamentous tissue of the UCL described by Garcia‐Elias and Domenech‐Mateu (1987), Nakamura et al . (1996), and Nakamura and Yabe (2000); (v) the dUCL, consisting of a thin layer of dense connective tissue lying in the deep lUCL (the dUCL is likely to correspond to subsheath of the extensor carpi ulnaris according to the reports of Nakamura et al ., 1996, and Nakamura & Yabe, 2000); and (vi) the IP consisting of a mixture of dense and loose connective tissues enclosed by the ADP, MH, RUL, dUCL, and lUCL (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The TFCC was subdivided into six regions, namely, the ADP, MH, RUL, dense part of UCL (dUCL), loose part of UCL (lUCL), and IP, in accordance with the descriptions of Taleisnik (1976), Palmer and Werner (1981), Garcia‐Elias and Domenech‐Mateu (1987), Nakamura (1995), Nakamura et al . (1996), Nakamura and Yabe (2000), and Nakamura et al .…”

Section: Methodsmentioning

confidence: 99%

“…The TFCC consists of the following components: the central portion of the triangular fibrocartilage (i.e. the articular disc proper (ADP) (articular disc (Kauer, 1975; Garcia‐Elias & Domenech‐Mateu, 1987; Benjamin et al ., 1990; Merida‐Velasco et al ., 1996); disc proper (Nakamura & Yabe, 2000); triangular articular disc (Lewis et al ., 1970))), meniscus homolog (MH) (Lewis et al ., 1970; Benjamin et al ., 1990; Nakamura & Yabe, 2000), radio‐ulnar ligament (RUL) (Benjamin et al ., 1990; Nakamura & Yabe, 2000), ulnar collateral ligament (UCL) (Lewis et al ., 1970; Benjamin et al ., 1990; Nakamura & Yabe, 2000), internal portion (IP) (Nakamura & Yabe, 2000), ulnolunate ligament, and ulnotriquetral ligament (Taleisnik, 1976; Palmer & Werner, 1981; Nakamura & Yabe, 2000; Nakamura et al ., 2001). The IP consists of a mixture of dense and loose connective tissues enclosed by ADP, MH, RUL, and UCL, and resides deep in the prestyloid recess (Lewis et al ., 1970; Kauer, 1975; Nakamura & Yabe, 2000), which is a pit in the MH.…”

Section: Introductionmentioning

confidence: 99%

“…The IP is identical to the ligamentum subcruentum (Kauer, 1975; Nakamura & Yabe, 2000). The UCL is located between the tip of the ulnar styloid process and the medial aspect of the triquetrum, and consists of both relatively loose ligamentous tissue and the extensor carpi ulnaris subsheath (Garcia‐Elias & Domenech‐Mateu, 1987; Nakamura et al ., 1996; Nakamura & Yabe, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Innervation of the triangular fibrocartilage complex of the human wrist: Quantitative immunohistochemical study

et al. 2007

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The distribution of neural elements in the triangular fibrocartilage complex (TFCC) of the human wrists was studied via immunohistochemical staining of protein gene product (PGP) 9.5 and calcitonin gene-related peptide (CGRP). Articular branches projecting to the TFCC arose from the dorsal branch of the ulnar nerve in all wrists examined. The TFCC is subdivided into the following six regions: the articular disc proper (ADP), meniscus homolog (MH), radio-ulnar ligament (RUL), loose part of ulnar collateral ligament (lUCL), dense part of ulnar collateral ligament (dUCL), and internal portion (IP). The IP consists of a mixture of dense and loose connective tissues enclosed by the ADP, MH, RUL, and UCL, and resides deep in the prestyloid recess, which is a pit in the MH. The densities of PGP 9.5-positive neural elements, including free nerve endings, single nerve fibers, nerve fascicles, and perivascular neural nets, were significantly higher in the IP than in other regions. Some of the neural elements except for the perivascular neural nets were positive for CGRP. The high density of neural elements in the IP suggests that sensory nerves projecting to the TFCC enter into the IP and from there distribute to adjacent regions such as the MH and RUL. Free nerve endings are responsible for pain transmission. The high density of free nerve endings in the IP suggests that the IP is a source of ulnar side wrist pain.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Innervation of the triangular fibrocartilage complex of the human wrist: Quantitative immunohistochemical study

et al. 2007

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“…2007). Its morphology and development (Palmer & Werner, 1981; Mohiuddin & Janjua, 1982; García‐Elias & Domenech‐Mateu, 1987; Mérida‐Velasco et al. 1996), histological fine structure (Benjamin et al.…”

Section: Introductionmentioning

confidence: 99%

Development and morphogenesis of human wrist joint during embryonic and early fetal period

et al. 2012

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The development of the human wrist joint has been studied widely, with the main focus on carpal chondrogenesis, ligaments and triangular fibrocartilage. However, there are some discrepancies concerning the origin and morphogenetic time-table of these structures, including nerves, muscles and vascular elements. For this study we used serial sections of 57 human embryonic (n = 30) and fetal (n = 27) specimens from O'Rahilly stages 17-23 and 9-14 weeks, respectively. The following phases in carpal morphogenesis have been established: undifferentiated mesenchyme (stage 17), condensated mesenchyme (stages 18 and 19), pre-chondrogenic (stages 19 and 20) and chondrogenic (stages 21 and over). Carpal chondrification and osteogenic processes are similar, starting with capitate and hamate (stage 19) and ending with pisiform (stage 22). In week 14, a vascular bud penetrates into the lunate cartilaginous mold, early sign of the osteogenic process that will be completed after birth. In stage 18, median, ulnar and radial nerves and thenar eminence appear in the hand plate. In stage 21, there are indications of the interosseous muscles, and in stage 22 flexor digitorum superficialis, flexor digitorum profundus and lumbrical muscles, transverse carpal ligament and collateral ligaments emerge. In stage 23, the articular disc, radiocarpal and ulnocarpal ligaments and deep palmar arterial arch become visible. Radiate carpal and interosseous ligaments appear in week 9, and in week 10, dorsal radiocarpal ligament and articular capsule are evident. Finally, synovial membrane is observed in week 13. We have performed a complete analysis of the morphogenesis of the structures of the human wrist joint. Our results present new data on nervous and arterial elements and provide the basis for further investigations on anatomical pathology, comparative morphology and evolutionary anthropology.

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Development of the human wrist joint ligaments

et al. 1996

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Background Many studies have been published on the development of the human wrist joint, but scant attention has been given to the development of the wrist joint ligaments. Moreover, traditional description of wrist anatomy usually depict only the superficial capsular fibers of the wrist joint. The only ligamentous structure to receive much attention is the articular disc of the wrist joint, which has been described as a fibro‐cartilaginous structure extending from the medial edge of the lower end of the radius to the ulnar styloid process. Methods In the present report, we synthesize our observations in the wrist joint ligaments in 35 serially sectioned human embryonic and fetal hands (16 embryos and 19 fetuses). Results The interosseous intercarpal ligaments are organized from the mesenchyme, which, until O'Rahilly's stage 23, fills the intercarpal spaces. These ligaments are not individually distinguishable until the 9th week of development. The collateral ligaments begin to form in O'Rahilly's stage 22 and are completely formed by the end of week 10. The palmar radiocarpal and ulnocarpal ligaments (beginning with the palmar radiocarpal ligament) begin to form in O'Rahilly's stage 23 and are fully developed by the end of week 10. At this time, development of the dorsal radiocarpal ligament begins; this process is completed by the end of week 13. The articular disc which is initially formed of a single element, first appears in O'Rahilly's stage 23 and its organization is completed at week 10 of development. Conclusions We establish the morphogenetic time‐table of the wrist joint ligaments. Our descriptive findings may help explain carpal motion and the origin of wrist injuries. © 1996 Wiley‐Liss, Inc.

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The Articular Disc of the Wrist. Limits and Relations

Cited by 33 publications

References 5 publications

Innervation of the triangular fibrocartilage complex of the human wrist: Quantitative immunohistochemical study

Innervation of the triangular fibrocartilage complex of the human wrist: Quantitative immunohistochemical study

Development and morphogenesis of human wrist joint during embryonic and early fetal period

Development of the human wrist joint ligaments

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