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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.
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]
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 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.
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.
The lunate bone (semilunar bone) is a carpal bone in the human hand. It is distinguished by its deep concavity and crescentic outline. It is situated in the center of the proximal row carpal bones, which lie between the ulna and radius and the hand. The lunate carpal bone is situated between the lateral scaphoid bone and medial triquetral bone.
The superior articular surfaces of the scaphoid, lunate, and triquetrum form a smooth convex surface, the condyle, which is received into the concavity. [7] Carpal bones of the hand: Proximal: A=Scaphoid, B=Lunate, C=Triquetrum, D=Pisiform; Distal: E=Trapezium, F=Trapezoid, G=Capitate, H=Hamate
Anatomic illustrations of the wrist depicting the progressive stages of scapholunate advanced collapse. (A) Normal wrist demonstrating an intact scapholunate ligament (white arrowhead), normal scapholunate interval, and preservation of the joint spaces. (S = scaphoid, L = lunate, C = capitate, R = radius, U = ulna).