Three‐dimensional analysis of the ligamentous attachments of the second through fifth carpometacarpal joints

Abstract

The purpose of this study is to clarify, measure, and show the anatomic locations and areas of specific ligamentous attachments and paths of the second through fifth carpometacarpal (CMC) joints on a three-dimensional (3D) surface model. Ten fresh-frozen cadaver wrists were used to dissect and identify the second through fifth CMC ligaments. Their ligamentous attachments and whole bone surfaces were digitized three-dimensionally and their areas calculated. The attachments of each ligament were represented in a model combining CT surfaces overlaid by a digitized 3D surface, and were also visually demonstrated with a specific color on 3D images of the bones. Nine dorsal and 11 palmar CMC ligaments and one CMC interosseous ligament were identified in the second through fifth CMC joints. An intra-articular ligament between the third metacarpal (MC), the fourth MC, capitate, and hamate was also identified. Five dorsal and five palmar intermetacarpal ligaments and three intermetacarpal interosseous ligaments were also identified in the second through fifth intermetacarpal joints. A previously undescribed palmar intermetacarpal ligament was located between the third, fourth, and fifth MC bases. The anatomic 3D attachment sites of the second through fifth CMC ligaments were visually depicted qualitatively, and their areas quantified. This 3D information will not only afford a better understanding of the anatomy and mechanics of the second through fifth CMC joints, but will also assist in the assessment of radiographic images and treatment of various injuries.

Three-dimensional Analysis of the Attachment and Path of the Transverse Carpal Ligament

“…We have previously described the average sizes of all ligamentous attachments except that of the TCL on each carpal bone 4 . In the current study, the attachment size of the TCL on the individual carpal bone was defined.…”

“…Recently, Manley et al 3 used digital photography and computer-aided image analysis to describe and quantify the two-dimensional footprint of the TCL attachment sites on the carpal bones. However, there has been little information detailing the specific location and area of ligamentous attachments on the threedimensional (3-D) surface of the metacarpals and carpal bones 4,5 . Currently, a number of techniques for carpal tunnel release have been reported.…”

Osseous and Ligamentous Scaphoid Anatomy: Part I. A Systematic Literature Review Highlighting Controversies

“…The attachment area on the scaphoid is many times larger than that on the capitate, and it covers a large area on the volar and ulnar surface of the distal scaphoid. 35,66 In an anatomic and biomechanical study, the ScC ligament consistently formed part of the scaphotrapezial ligament complex and was considered to be an important stabilizer of the midcarpal joint. 62 No controversial findings are reported in the literature.…”

Wrist Anatomy and Biomechanics

“…Extrinsic ligaments connect the distal radius and ulna to the carpal bones, and intrinsic ligaments have their origins and insertions within the carpal bones. 2 Nagao et al 4 and Nanno et al 5,6 made computed tomography images of wrists, from which 3-dimensional images of the bones were modeled, and the ligament attachment areas thereupon are listed in Table 1. The presence or absence of each ligament is also noted.…”