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Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
Moving distally from the wrist to the fingertips, there are the following joints: carpometacarpal, intermetacarpal, metacarpophalangeal, and proximal and distal interphalangeal joints. Each joint has several ligaments associated with it. The carpometacarpal and intermetacarpal joints are supported by anterior, posterior and interosseous ligaments. The metacarpophalangeal joint (knuckle) has a more complex arrangement of ligaments. Anteriorly, strong palmar ligaments run from the distal end of the metacarpal to the proximal end of the proximal phalanx. Medial and lateral collateral ligaments also pass from the metacarpal to the phalanx. Additionally, the second to fifth metacarpal heads are linked together by deep transverse metacarpal ligaments. The arrangement of palmar and collateral ligaments is repeated at the interphalangeal joints of the digits.
Biomechanics of the Hand and Wrist
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Nicholas Saw, Livio Di Mascio, David Evans
Movement at the carpometacarpal (CMC) joints of the fingers is limited, especially in the index and middle fingers. These two metacarpals are bound rigidly to the distal carpal row and transmit the forces from hand to wrist. The middle finger metacarpal acts as a cantilever from which a strong fibrous framework extends, attaching to and holding in place the flexor sheaths. This framework, mediated through the collateral ligaments to the deep transverse metacarpal ligament, suspends the flexor mechanisms from the metacarpal heads and transverse arch. In rheumatoid arthritis, the synovitis weakens the radial collateral ligaments in particular and disrupts the attachments to the arch, with secondary consequences such as extensor tendon subluxation, MCP joint subluxation, ulnar drift and loss of flexion power.
Innervation of the lumbrical and interosseous muscles in hand: analysis of distribution of nerve fascicles and quantification of their surface projections
Published in Journal of Plastic Surgery and Hand Surgery, 2022
In Group 1, the L4 branch traversed along the ulnar aspect of the third palmar interosseus (PI3). At the proximal level of the deep transverse metacarpal ligament, it divided into two branches; a branch ran straight to supply the fifth metacarpophalangeal joint and the other traversed in the radial direction to supply the L4. In one specimen, the fifth metacarpal was obviously short, and the hypothenar muscles exhibited remarkable atrophy. Due to the variations, the location of the entrance of the branch to the L4 was more proximal and ulnar than the others (Figure 3, data pertaining to its entrance is excluded). The branch to the PI3 accompanied the branch to the L4 for a short distance and entered the palmar aspect of the PI3. After its exit from dUN, the branch to the fourth dorsal interosseus (DI4) traveled deeply to supply the DI4 (Figure 9).