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The most frequently performed surgery is the Proximal Row Carpectomy, where the lunate, scaphoid and triquetrum are extracted. This greatly limits the range of motion of the wrist, but pain relief can be achieved for longer than after the other surgeries.
The cavity of the midcarpal joint is very extensive and irregular. The major portion of the cavity is located between the distal surfaces of the scaphoid, lunate, and triquetrum and proximal surfaces of the four bones of the distal row. Proximal prolongations of the cavity occur between the scaphoid and lunate and between the lunate and triquetrum.
Ulnar triquetral column: triquetrum and hamate; In this context the pisiform is regarded as a sesamoid bone embedded in the tendon of the flexor carpi ulnaris. [4] The ulnar column leaves a gap between the ulna and the triquetrum, and therefore, only the radial or scaphoid and central or capitate columns articulate with the radius.
The scaphoid can be slow to heal because of the limited circulation to the bone. Fractures of the scaphoid must be recognized and treated quickly, as prompt treatment by immobilization or surgical fixation increases the likelihood of the bone healing in anatomic alignment, thus avoiding mal-union or non-union. [6] Delays may compromise healing.
In part based on these concerns, some surgeon prefer to maintain the lunate in patients younger than 40 years proximal row carpectomy. [6] [18] A surgery called four-corner arthrodesis is an option. [6] The capitate, lunate, hamate and triquetrum are fused together in this procedure and the scaphoid is excised.
The joints of the proximal row are arthrodial joints, The scaphoid, lunate, and triquetrum are connected by dorsal, volar, and interosseous ligaments.. The dorsal intercarpal ligament are two in number and placed transversely behind the bones of the first row; they connect the scaphoid and lunate, and the lunate and triquetrum.
An example of a coalition between the trapezoid and capitate carpal bones. The lunate and triquetral bones are the most common carpal bones to fuse together, resulting in a lunotriquetral coalition in 1% of people. 60% of patients with a lunotriquetral coalition will have it bilaterally. [1]
The scapholunate ligament is an intraarticular ligament binding the scaphoid and lunate bones of the wrist together. It is divided into three areas, dorsal, proximal and palmar, with the dorsal segment being the strongest part. [3] It is the main stabilizer of the scaphoid. In contrast to the scapholunate ligament, the lunotriquetral ligament ...