Abstract：
OBJECTIVE: There is consensus in favor of a description of the dorsal ligaments of the carpus as not including a direct ligament between the lunate and capitate. On the other hand, there is an anatomical formation which, according to the currently accepted description, corresponds to the dorsal midcarpal capsule, itself thickened by the dorsal intercarpal ligament. The question is whether the capsule at this point deserves to be called an individualizable ligament. In our operative experience of the dorsal carpus, we have encountered a stout structure adherent to the lunate and capitate. In this article, we present the anatomic evidence of this structure\'s existence.
METHODS: Seven adult fresh frozen upper extremities were dissected. Three wrists were longitudinally sectioned in line with the middle finger metacarpal. The remaining 4 were dissected dorsally. Two representative samples of the stout structure connecting the lunate to the capitate were sent to pathology for histologic analysis and staining.
RESULTS: In all 3 of the longitudinally sectioned wrists, a thick band of tissue could clearly be seen, originating on the lunate, spanning the dorsal interval between the lunate and the capitate, and inserting on the capitate. With this structure intact, dorsal dislocation of the capitate was not possible, but preliminary sectioning of the structure allowed dislocation. In the 4 dorsally dissected wrists, the same connection was observed, palmar to the dorsal intercarpal ligament, in every specimen. The average dimensions of the dorsal capitolunate were: 15.25 ± 1 mm long, 8.75 ± 1 mm wide at the midpoint, and 1.75 ± 1 mm thick. The two specimens sent to pathology after sectioning showed longitudinally oriented collagen fibers. This structure also stained positive for elastin and contained intrasubstance vascular structures.
CONCLUSIONS: There is a stout ligamentous structure connecting the lunate to the capitate, palmar to the dorsal intercarpal ligament. Disruption of this structure appears to be necessary for dorsal dislocation of the capitate. Clinical studies are needed to gain better understanding of the exact function and importance of this structure.
METHODS: Seven adult fresh frozen upper extremities were dissected. Three wrists were longitudinally sectioned in line with the middle finger metacarpal. The remaining 4 were dissected dorsally. Two representative samples of the stout structure connecting the lunate to the capitate were sent to pathology for histologic analysis and staining.
RESULTS: In all 3 of the longitudinally sectioned wrists, a thick band of tissue could clearly be seen, originating on the lunate, spanning the dorsal interval between the lunate and the capitate, and inserting on the capitate. With this structure intact, dorsal dislocation of the capitate was not possible, but preliminary sectioning of the structure allowed dislocation. In the 4 dorsally dissected wrists, the same connection was observed, palmar to the dorsal intercarpal ligament, in every specimen. The average dimensions of the dorsal capitolunate were: 15.25 ± 1 mm long, 8.75 ± 1 mm wide at the midpoint, and 1.75 ± 1 mm thick. The two specimens sent to pathology after sectioning showed longitudinally oriented collagen fibers. This structure also stained positive for elastin and contained intrasubstance vascular structures.
CONCLUSIONS: There is a stout ligamentous structure connecting the lunate to the capitate, palmar to the dorsal intercarpal ligament. Disruption of this structure appears to be necessary for dorsal dislocation of the capitate. Clinical studies are needed to gain better understanding of the exact function and importance of this structure.
摘要：
目的：人们一致认为，腕背韧带不包括月牙和头状的直接韧带。另一方面,有一个解剖结构，根据目前接受的描述，对应于背中腕囊，本身被背侧腕间韧带增厚。问题是，此时的胶囊是否值得被称为可个性化的韧带。根据我们对背腕骨的手术经验，我们遇到了一个坚固的结构，它粘附在月球和头颅上。在这篇文章中,我们提供了这种结构存在的解剖学证据。
方法：解剖7例成人新鲜冷冻上肢。将三个手腕与中指掌骨纵向切开。其余4只在背侧解剖。将两个将月球连接到头状的粗壮结构的代表性样品送至病理学进行组织学分析和染色。
结果：在所有3个纵向切开的手腕中，可以清楚地看到一条厚厚的组织带，起源于月球，跨越月头和头颅之间的背侧间隔，插入在头端。这个结构完好无损，头端背侧脱位是不可能的，但是对结构的初步切片允许位错。在4个背侧解剖的手腕上，观察到相同的连接，手掌到腕间背侧韧带,在每个标本中。头状背的平均尺寸为：15.25±1mm长，中点宽8.75±1mm,和1.75±1毫米厚。切片后送至病理的两个标本显示纵向胶原纤维。该结构也对弹性蛋白染色阳性，并包含支架内血管结构。
结论：有一个坚固的韧带结构将月头连接到头状，手掌到腕间背侧韧带。这种结构的破坏似乎对于头颅的背侧脱位是必要的。临床研究需要更好地了解这种结构的确切功能和重要性。
方法：解剖7例成人新鲜冷冻上肢。将三个手腕与中指掌骨纵向切开。其余4只在背侧解剖。将两个将月球连接到头状的粗壮结构的代表性样品送至病理学进行组织学分析和染色。
结果：在所有3个纵向切开的手腕中，可以清楚地看到一条厚厚的组织带，起源于月球，跨越月头和头颅之间的背侧间隔，插入在头端。这个结构完好无损，头端背侧脱位是不可能的，但是对结构的初步切片允许位错。在4个背侧解剖的手腕上，观察到相同的连接，手掌到腕间背侧韧带,在每个标本中。头状背的平均尺寸为：15.25±1mm长，中点宽8.75±1mm,和1.75±1毫米厚。切片后送至病理的两个标本显示纵向胶原纤维。该结构也对弹性蛋白染色阳性，并包含支架内血管结构。
结论：有一个坚固的韧带结构将月头连接到头状，手掌到腕间背侧韧带。这种结构的破坏似乎对于头颅的背侧脱位是必要的。临床研究需要更好地了解这种结构的确切功能和重要性。
