TOTBİD Dergisi

TOTBİD Dergisi

2011, Cilt 10, Sayı, 1     (Sayfalar: 018-024)

The anatomy of the wrist and the carpal tunnel

Tülin Şen 1, Mahmut Kömürcü 2

1 Ankara Üniversitesi Tıp Fakültesi, Anatomi Anabilim Dalı, Ankara
2 Fatih Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Ankara

Görüntüleme: 817
İndirme : 4829

The skeleton of the wrist is made up of eight carpal bones. They articulate with the bones of forearm proximally and metacarpal bones distally. The ulna does not articulate with the wrist joint. The wrist joint ligaments situated between the fibrous and synovial layers of the wrist joint are intracapsular (Intrinsic), while those lying superficial to the fibrous layer are extracapsular (Extrinsic) ligaments. These ligaments are named from proximal to distal and from radial to ulnar based on the structures they extend to. The triangular fibrocartilage complex, which is the primary stabilizer of the distal radioulnar joint, is involved in absorption of the stress on the wrist in the axial direction and limitation of the lateral deviation of the wrist. The antebrachial fascia thickens on the palmar side where it attaches to the radius and the ulna. This thickening is called as flexor retinaculum. Carpal transvers ligament, which forms the main part of the flexor retinaculum attaches medially to pisiform and the hook of hamate, extends laterally and splits into a superficial and a deep lamina. The supercifial lamina attaches to the lateral aspect of the tubercle of scaphoid and the groove of trapezium, while the deep lamina attaches to the medial edge of this groove. The tendon of flexor carpi radialis passes through the space delimited by these two laminae and trapezium. The passage formed between these two laminae and the carpal bones is called the `carpal tunnel` and flexor muscle sinews and the median nerve pass through this space and reach the hand. The ulnar vessels and nerve and the cutaneous branch of the median nerve pass superficial to the flexor retinaculum and lateral to pisiform. A thin layer of fascial band passes over these neurovascular structures and attaches to the radial side of the pisiform forming the `Guyon`s canal`. The compression of the nerves in in both canals may cause entrapment neuropathies.

Anahtar Kelimeler : Anatomy; carpal tunnel; Guyon`s canal; wrist joint