Document Detail

The carpal insertions of the transverse carpal ligament.
MedLine Citation:
PMID:  23537443     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: To quantitatively define the anatomic insertions of the transverse carpal ligament (TCL) to the carpals.
METHODS: We dissected 5 fresh-frozen cadaver limbs, isolating the TCL. The ligament insertion sites into bone were clearly marked and photographed. We then used computer software to measure the area of insertion into the individual carpals.
RESULTS: The TCL had consistent insertion sites into the scaphoid, trapezium, pisiform, and hamate. The average insertion of the TCL on the scaphoid was 6 × 6 mm (proximal to distal × radial to ulnar maximum distance), trapezium 13 × 6 mm, pisiform 9 × 6 mm, and hamate 11 × 5 mm. The area of ligament insertion on the scaphoid was 29 mm(2), trapezium was 42 mm(2), pisiform was 38 mm(2), and hamate was 40 mm(2). The perimeter of the ligament insertion on the scaphoid was 21 mm, trapezium was 28 mm, pisiform was 25 mm, and hamate was 29 mm.
CONCLUSIONS: The TCL has a broad but definable footprint on the trapezium and scaphoid on the radial side and the hamate and the pisiform on the ulnar side of the carpal tunnel. The distal carpal insertion sites are longer and oblong, whereas the proximal insertion sites are more circular.
CLINICAL RELEVANCE: Precise knowledge of TCL attachment sites may allow the surgeon greater confidence and safety during procedures that involve its release, such as carpal tunnel release, trapeziectomy, hook of hamate excision, or Guyon canal release.
Mollie Manley; Matthew Boardman; Robert J Goitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  38     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  729-32     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
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