Ligamentous anatomy of the medial carpal region.

The purpose of this study is to elucidate the ligamentous anatomy of the medial carpus in order to characterize the pathologic basis of pisiform subluxation secondary to traumatic ligament rupture. Medial carpal ligamentous anatomy has been studied in the past by anatomic dissection and analyzed in terms of comparative morphology. A review of this literature reveals that the anatomy of the region requires further definition. We have performed cadaveric dissections that reveal that the ulnar or medial carpal ligament complex is composed of three structures: (1) the triangular fibrocartilage, (2) the meniscus homologue, and (3) the ulnar collateral ligament. We conclude that the medial carpal ligament complex has an insertion into the pisiform bone.