The articular disc of the hand

Area of Science:

• Anatomy
• Embryology
• Hand Surgery

Background:

• The carpal articular disc's detailed structure and developmental origins are not fully understood.
• Previous studies have not comprehensively described its fibrous connections and anatomical relationships within the wrist.

Purpose of the Study:

• To investigate the embryological and fetal development of the carpal articular disc.
• To delineate the full extent and attachments of the carpal articular disc.
• To clarify the relationship between the disc, surrounding fascia, tendons, and specific wrist joint spaces.

Main Methods:

• Serial sectioning of embryonal and fetal human hands.
• Detailed anatomical dissection and microscopic examination of the carpal articular disc and associated structures.

Main Results:

• The carpal articular disc is an extensive fibrous system originating from the ulnar edge of the distal radius and extending to the base of metacarpal V.
• The disc integrates with the deep antebrachial fascia and has insertions into the ulna head, ulnar styloid process, and ulnar carpals.
• The sheath of the extensor carpi ulnaris tendon is identified as part of this fibrous system, with tendon positions shifting during hand rotation.

Conclusions:

• The carpal articular disc is a complex fibrous system with significant anatomical connections in the wrist.
• The study establishes relationships between the ligamentum subcruentum, prestyloid recess, and discusses cartilaginous primordia.
• Current evidence is insufficient to draw parallels between phylogenetic and human embryological development of the disc; the development of the pisotriquetral joint space is highlighted.