The capsular ligaments of the wrist: morphology, morphometry and clinical applications

Variable wrist ligament descriptions and nomenclatures have been presented, but the dimensions of these ligaments have not yet been extensively invest igated. To verify the numerous concepts advanced and to provide a better un derstanding of individual variations in carpal biomechanics, and the numero us pathomechanical concepts reported in the literature, this study aimed to determine capsular carpal ligament anatomy, their dimensions and variation s. The origin, insertion, and number of fascicles of the capsular wrist lig aments were observed in precise dissection of 66 anatomic preparations. The dimensions of several capsular wrist ligaments were measured using a calli per: the parameters analysed being length and width at three levels each, f rom which mean length and width and approximate mean surface (product of me an length by mean width) were determined. The anatomy of the capsular ligam ents of the wrist showed, besides relatively constant structures; considera ble individual variations, particularly of the ulnocarpal and dorsal ligame nts; The standard deviations of ligament lengths and widths were mostly les s than 20% of the average value. Some measurements, however, showed larger variations, such as those associated with the dorsal scaphotriquetral and u lnocarpal ligaments. Ligament widths generally showed larger variations and less interdependency than did ligament lengths. The capsular wrist ligamen ts display morphologic and morphometric variations, which could explain the biomechanical variations reported in the literature, and the diversity of classifications and treatment methods proposed for carpal instability. Furt her studies, however, are needed to confirm this hypothesis.