The Dorsal Ligament Complex: A Cadaveric, Histology, and Imaging Study

Area of Science:

• Orthopedic Surgery
• Anatomy
• Radiology

Background:

• The precise distinction between dorsal intercarpal (DIC) and dorsal scaphotriquetral (DST) ligaments is not well-defined in existing literature.
• Accurate anatomical knowledge is crucial for effective surgical interventions in the wrist.

Purpose of the Study:

• To precisely define the origins, insertions, and anatomical relationships of dorsal wrist ligaments.
• To correlate these anatomical findings with magnetic resonance imaging (MRI) and histological data.

Main Methods:

• Dissection of 17 fresh-frozen cadaveric wrist specimens (excluding those with arthritis or malalignment).
• Measurement of ligament insertion sites in radioulnar and proximodistal dimensions.
• Histological analysis of three specimens and MRI with 3D modeling of three additional cadavers.

Main Results:

• The conjoined triquetral insertion of DIC, DST, and dorsal radiocarpal (DRC) ligaments measured 88.5 ± 6.4 mm².
• Two distinct deep and superficial intercarpal fiber components were identified, with the deep component inserting on the lunate.
• The dorsal ligament complex creates a strong connection across the proximal carpal row, with the DST extending over the capitate.

Conclusions:

• The dorsal ligament complex provides a stable link within the proximal carpal row.
• The dorsal scaphotriquetral ligament contributes to the extension of the proximal carpal row over the capitate.