Three-Dimensional Imaging of the Carpal Ligaments

New and more detailed information on the skeletal morphology of the wrist and hand has been reported over the past 2 decades. This new information and better understanding of the ligament anatomy can help surgeons diagnose and treat the wrist, assess wrist images, and perform wrist arthroscopy. The recent work of Nagao and colleagues [3] and Nanno and colleagues [22,23] have shown the value of 3-D surface modeling in determining the specific locations and areas of ligament attachments of the distal radius, carpal, and metacarpal bones. Combining 3-D CT bone modeling with a 3-D depiction of the ligament attachments provides a better knowledge of the interrelation of the radiocarpal, carpal, and CMC ligaments and their attachments through visual illustration. These methods can also provide a better understanding of the pathomechanics in various wrist injuries, including injuries of the carpal ligaments. A more complete understanding of the anatomic location of the ligament attachments is important, particularly in their relation to the isometric points and kinematics of the carpal bones, the metacarpals, and ligament mechanics. This additional knowledge of the ligaments will help provide further understanding of wrist kinematics and, more precisely, the function of the individual ligaments and their roles in joint motion and stability and injuries.