Pediatric Radiology

, Volume 48, Issue 6, pp 764–782 | Cite as

Anatomy and injuries of the pediatric wrist: beyond the basics

  • Ezekiel Maloney
  • Andrew M. Zbojniewicz
  • Jie Nguyen
  • Yu Luo
  • Mahesh M. Thapa


Ligamentous injuries of the pediatric wrist, once thought to be relatively uncommon, are increasingly recognized in the context of acute high-energy mechanism trauma and chronic axial loading, including those encountered in both recreational and high-performance competitive sports. Recent advances in MR-based techniques for imaging the pediatric wrist allow for sensitive identification of these often radiographically occult injuries. Detailed knowledge of the intrinsic and supportive extrinsic ligamentous complexes, as well as normal developmental anatomy and congenital variation, are essential to accurately diagnose injuries to these structures. Early identification of ligamentous injury of the pediatric wrist is essential within the conservative treatment culture of modern pediatric orthopedics because treatment of these lesions often necessitates surgery, and outcomes often depend on early and sometimes aggressive intervention. In this article, we review MR arthrogram technique and pediatric wrist anatomy, and correlate appearances on MR and selected ligamentous pathologies of the pediatric wrist.


Children Imaging Injury Magnetic resonance arthrography Magnetic resonance imaging Wrist 



Dr. Maloney is supported, in part, through a National Institutes of Health, National Research Service Award training grant held by the University of Washington Gastroenterology Division.

Compliance with ethical standards

Conflicts of interest



  1. 1.
    Larson RL, McMahan RO (1966) The epiphyses and the childhood athlete. JAMA 196:607–612PubMedCrossRefGoogle Scholar
  2. 2.
    Flachsmann R, Broom ND, Hardy AE, Moltschaniwskyj G (2000) Why is the adolescent joint particularly susceptible to osteochondral shear fracture? Clin Orthop Relat Res 2000:212–221CrossRefGoogle Scholar
  3. 3.
    Micheli LJ (1986) Pediatric and adolescent sports injuries: recent trends. Exerc Sport Sci Rev 14:359–374PubMedCrossRefGoogle Scholar
  4. 4.
    Davis KW, Gill KG (2012) Upper extremity injuries in young athletes. Semin Musculoskelet Radiol 16:269–279PubMedCrossRefGoogle Scholar
  5. 5.
    Naranje SM, Erali RA, Warner WC Jr et al (2016) Epidemiology of pediatric fractures presenting to emergency departments in the United States. J Pediatr Orthop 36:e45–e48PubMedCrossRefGoogle Scholar
  6. 6.
    Vadivelu R, Dias JJ, Burke FD, Stanton J (2006) Hand injuries in children: a prospective study. J Pediatr Orthop 26:29–35PubMedCrossRefGoogle Scholar
  7. 7.
    Taylor BL, Attia MW (2000) Sports-related injuries in children. Acad Emerg Med 7:1376–1382PubMedCrossRefGoogle Scholar
  8. 8.
    Leininger RE, Knox CL, Comstock RD (2007) Epidemiology of 1.6 million pediatric soccer-related injuries presenting to US emergency departments from 1990 to 2003. Am J Sports Med 35:288–293PubMedCrossRefGoogle Scholar
  9. 9.
    Zalavras C, Nikolopoulou G, Essin D (2005) Pediatric fractures during skateboarding, roller skating, and scooter riding. Am J Sports Med 33:568–573PubMedCrossRefGoogle Scholar
  10. 10.
    O'Neill DF, McGlone MR (1999) Injury risk in first-time snowboarders versus first-time skiers. Am J Sports Med 27:94–97PubMedCrossRefGoogle Scholar
  11. 11.
    Bateni CP, Bartolotta RJ, Richardson ML et al (2013) Imaging key wrist ligaments: what the surgeon needs the radiologist to know. AJR Am J Roentgenol 200:1089–1095PubMedCrossRefGoogle Scholar
  12. 12.
    Theumann NH, Etechami G, Duvoisin B et al (2006) Association between extrinsic and intrinsic carpal ligament injuries at MR arthrography and carpal instability at radiography: initial observations. Radiology 238:950–957PubMedCrossRefGoogle Scholar
  13. 13.
    Shahabpour M, De Maeseneer M, Pouders C et al (2011) MR imaging of normal extrinsic wrist ligaments using thin slices with clinical and surgical correlation. Eur J Radiol 77:196–201PubMedCrossRefGoogle Scholar
  14. 14.
    Kaawach W, Ecklund K, Di Canzio J et al (2001) Normal ranges of scapholunate distance in children 6 to 14 years old. J Pediatr Orthop 21:464–467PubMedGoogle Scholar
  15. 15.
    Terry CL, Waters PM (1998) Triangular fibrocartilage injuries in pediatric and adolescent patients. J Hand Surg Am 23:626–634PubMedCrossRefGoogle Scholar
  16. 16.
    Magee T (2009) Comparison of 3-T MRI and arthroscopy of intrinsic wrist ligament and TFCC tears. AJR Am J Roentgenol 192:80–85PubMedCrossRefGoogle Scholar
  17. 17.
    Braun H, Kenn W, Schneider S et al (2003) Direct MR arthrography of the wrist — value in detecting complete and partial defects of intrinsic ligaments and the TFCC in comparison with arthroscopy. Rofo 175:1515–1524PubMedCrossRefGoogle Scholar
  18. 18.
    Brown RR, Fliszar E, Cotten A et al (1998) Extrinsic and intrinsic ligaments of the wrist: normal and pathologic anatomy at MR arthrography with three-compartment enhancement. Radiographics 18:667–674PubMedCrossRefGoogle Scholar
  19. 19.
    Lee YH, Choi YR, Kim S et al (2013) Intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist: comparison of isovolumetric 3D-THRIVE sequence MR arthrography and conventional MR image at 3 T. Magn Reson Imaging 31:221–226PubMedCrossRefGoogle Scholar
  20. 20.
    Smith TO, Drew B, Toms AP et al (2012) Diagnostic accuracy of magnetic resonance imaging and magnetic resonance arthrography for triangular fibrocartilaginous complex injury: a systematic review and meta-analysis. J Bone Joint Surg Am 94:824–832PubMedCrossRefGoogle Scholar
  21. 21.
    Maizlin ZV, Brown JA, Clement JJ et al (2009) MR arthrography of the wrist: controversies and concepts. Hand 4:66–73PubMedCrossRefGoogle Scholar
  22. 22.
    Bae DS, Waters PM (2006) Pediatric distal radius fractures and triangular fibrocartilage complex injuries. Hand Clin 22:43–53PubMedCrossRefGoogle Scholar
  23. 23.
    Cooney WP, Linscheid RL, Dobyns JH (1994) Triangular fibrocartilage tears. J Hand Surg Am 19:143–154PubMedCrossRefGoogle Scholar
  24. 24.
    Stehling C, Langer M, Bachmann R et al (2009) Three-tesla magnetic resonance imaging of the wrist: diagnostic performance compared to 1.5-T. J Comput Assist Tomogr 33:934–939PubMedCrossRefGoogle Scholar
  25. 25.
    Taljanovic MS, Malan JJ, Sheppard JE (2012) Normal anatomy of the extrinsic capsular wrist ligaments by 3-T MRI and high-resolution ultrasonography. Semin Musculoskelet Radiol 16:104–114PubMedCrossRefGoogle Scholar
  26. 26.
    Moser T, Dosch JC, Moussaoui A et al (2008) Multidetector CT arthrography of the wrist joint: how to do it. Radiographics 28:787–800PubMedCrossRefGoogle Scholar
  27. 27.
    Linkous MD, Gilula LA (1998) Wrist arthrography today. Radiol Clin North Am 36:651–672PubMedCrossRefGoogle Scholar
  28. 28.
    Choudur HN, Ellins ML (2011) Ultrasound-guided gadolinium joint injections for magnetic resonance arthrography. J Clin Ultrasound 39:6–11PubMedCrossRefGoogle Scholar
  29. 29.
    Hilfiker PR, Weishaupt D, Schmid M et al (1999) Real-time MR-guided joint puncture and arthrography: preliminary results. Eur Radiol 9:201–204PubMedCrossRefGoogle Scholar
  30. 30.
    Otjen J, Parnell SE, Menashe S, Thapa MM (2015) Ultrasound-guided joint injections for MR arthrography in pediatric patients: how we do it. Pediatr Radiol 45:308–316PubMedCrossRefGoogle Scholar
  31. 31.
    Trattnig S, Breitenseher M, Pretterklieber M et al (1997) MR-guided joint puncture and real-time MR-assisted contrast media application. Acta Radiol 38:1047–1049PubMedCrossRefGoogle Scholar
  32. 32.
    Cerezal L, de Dios Berna-Mestre J, Canga A et al (2012) MR and CT arthrography of the wrist. Semin Musculoskelet Radiol 16:27–41PubMedCrossRefGoogle Scholar
  33. 33.
    Ruegger C, Schmid MR, Pfirrmann CW et al (2007) Peripheral tear of the triangular fibrocartilage: depiction with MR arthrography of the distal radioulnar joint. AJR Am J Roentgenol 188:187–192PubMedCrossRefGoogle Scholar
  34. 34.
    De Filippo M, Pogliacomi F, Bertellini A et al (2010) MDCT arthrography of the wrist: diagnostic accuracy and indications. Eur J Radiol 74:221–225PubMedCrossRefGoogle Scholar
  35. 35.
    Omlor G, Jung M, Grieser T, Ludwig K (2009) Depiction of the triangular fibro-cartilage in patients with ulnar-sided wrist pain: comparison of direct multi-slice CT arthrography and direct MR arthrography. Eur Radiol 19:147–151PubMedCrossRefGoogle Scholar
  36. 36.
    Cerezal L, Abascal F, Garcia-Valtuille R, Del Pinal F (2005) Wrist MR arthrography: how, why, when. Radiol Clin N Am 43:709–731PubMedCrossRefGoogle Scholar
  37. 37.
    Dwek JR (2010) The periosteum: what is it, where is it, and what mimics it in its absence? Skelet Radiol 39:319–323CrossRefGoogle Scholar
  38. 38.
    Gray DJ, Gardner E, O'Rahilly R (1957) The prenatal development of the skeleton and joints of the human hand. Am J Anat 101:169–223PubMedCrossRefGoogle Scholar
  39. 39.
    Greulich WW, Pyle S (1959) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford University Press, StanfordGoogle Scholar
  40. 40.
    Egol K, Koval KJ, Zuckerman JD (2010) Handbook of fractures, 4th edn. Lippincott Williams & Wilkins, Philadelphia, pp 660–680Google Scholar
  41. 41.
    Merida-Velasco JA, Garcia-Garcia JD, Espin-Ferra J, Sanchez-Montesinos I (1996) Development of the human wrist joint ligaments. Anat Rec 245:114–121PubMedCrossRefGoogle Scholar
  42. 42.
    Defazio MV, Cousins BJ, Miversuski RA Jr, Cardoso R (2013) Carpal coalition: a review of current knowledge and report of a single institution's experience with asymptomatic intercarpal fusion. Hand 8:157–163PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Ogden J (1982) Skeletal injury in the child. Lea & Febiger, Philadelphia, pp 358–384Google Scholar
  44. 44.
    Little JT, Klionsky NB, Chaturvedi A et al (2014) Pediatric distal forearm and wrist injury: an imaging review. Radiographics 34:472–490PubMedCrossRefGoogle Scholar
  45. 45.
    Tan AB, Tan SK, Yung SW et al (1995) Congenital perforations of the triangular fibrocartilage of the wrist. J Hand Surg Br 20:342–345PubMedCrossRefGoogle Scholar
  46. 46.
    Berger RA (2001) The anatomy of the ligaments of the wrist and distal radioulnar joints. Clin Orthop Relat Res 2001:32–40CrossRefGoogle Scholar
  47. 47.
    Daunt N (2002) Magnetic resonance imaging of the wrist: anatomy and pathology of interosseous ligaments and the triangular fibrocartilage complex. Curr Probl Diagn Radiol 31:158–176PubMedCrossRefGoogle Scholar
  48. 48.
    Shin AY, Battaglia MJ, Bishop AT (2000) Lunotriquetral instability: diagnosis and treatment. J Am Acad Orthop Surg 8:170–179PubMedCrossRefGoogle Scholar
  49. 49.
    Yoshioka H, Tanaka T, Ueno T et al (2006) High-resolution MR imaging of the proximal zone of the lunotriquetral ligament with a microscopy coil. Skelet Radiol 35:288–294CrossRefGoogle Scholar
  50. 50.
    Burns JE, Tanaka T, Ueno T et al (2011) Pitfalls that may mimic injuries of the triangular fibrocartilage and proximal intrinsic wrist ligaments at MR imaging. Radiographics 31:63–78PubMedCrossRefGoogle Scholar
  51. 51.
    Zlatkin MB, Rosner J (2004) MR imaging of ligaments and triangular fibrocartilage complex of the wrist. Magn Reson Imaging Clin N Am 12:301–331PubMedCrossRefGoogle Scholar
  52. 52.
    Robinson G, Chung T, Finlay K, Friedman L (2006) Axial oblique MR imaging of the intrinsic ligaments of the wrist: initial experience. Skelet Radiol 35:765–773CrossRefGoogle Scholar
  53. 53.
    Sokolow C, Saffar P (2001) Anatomy and histology of the scapholunate ligament. Hand Clin 17:77–81PubMedGoogle Scholar
  54. 54.
    Mikic ZD (1984) Arthrography of the wrist joint. An experimental study. J Bone Joint Surg Am 66:371–378PubMedCrossRefGoogle Scholar
  55. 55.
    Berger RA (1996) The gross and histologic anatomy of the scapholunate interosseous ligament. J Hand Surg Am 21:170–178PubMedCrossRefGoogle Scholar
  56. 56.
    Totterman SM, Miller RJ (1996) Scapholunate ligament: normal MR appearance on three-dimensional gradient-recalled-echo images. Radiology 200:237–241PubMedCrossRefGoogle Scholar
  57. 57.
    Smith DK (1994) Scapholunate interosseous ligament of the wrist: MR appearances in asymptomatic volunteers and arthrographically normal wrists. Radiology 192:217–221PubMedCrossRefGoogle Scholar
  58. 58.
    Tanaka T, Ogino S, Yoshioka H (2008) Ligamentous injuries of the wrist. Semin Musculoskelet Radiol 12:359–377PubMedCrossRefGoogle Scholar
  59. 59.
    Hogikyan JV, Louis DS (1992) Embryologic development and variations in the anatomy of the ulnocarpal ligamentous complex. J Hand Surg Am 17:719–723PubMedCrossRefGoogle Scholar
  60. 60.
    Bednar MS, Arnoczky SP, Weiland AJ (1991) The microvasculature of the triangular fibrocartilage complex: its clinical significance. J Hand Surg Am 16:1101–1105PubMedCrossRefGoogle Scholar
  61. 61.
    Thiru RG, Ferlic DC, Clayton ML, McClure DC (1986) Arterial anatomy of the triangular fibrocartilage of the wrist and its surgical significance. J Hand Surg Am 11:258–263PubMedCrossRefGoogle Scholar
  62. 62.
    Mikic Z (1992) The blood supply of the human distal radioulnar joint and the microvasculature of its articular disk. Clin Orthop Relat Res 1992:19–28Google Scholar
  63. 63.
    Timins ME, O'Connell SE, Erickson SJ, Oneson SR (1996) MR imaging of the wrist: normal findings that may simulate disease. Radiographics 16:987–995PubMedCrossRefGoogle Scholar
  64. 64.
    Totterman SM, Miller RJ, McCance SE, Meyers SP (1996) Lesions of the triangular fibrocartilage complex: MR findings with a three-dimensional gradient-recalled-echo sequence. Radiology 199:227–232PubMedCrossRefGoogle Scholar
  65. 65.
    Oneson SR, Scales LM, Timins ME et al (1996) MR imaging interpretation of the palmer classification of triangular fibrocartilage complex lesions. Radiographics 16:97–106PubMedCrossRefGoogle Scholar
  66. 66.
    Yoshioka H, Tanaka T, Ueno T et al (2007) Study of ulnar variance with high-resolution MRI: correlation with triangular fibrocartilage complex and cartilage of ulnar side of wrist. J Magn Reson Imaging 26:714–719PubMedCrossRefGoogle Scholar
  67. 67.
    Taleisnik J (1976) The ligaments of the wrist. J Hand Surg Am 1:110–118PubMedCrossRefGoogle Scholar
  68. 68.
    Haims AH, Schweitzer ME, Morrison WB et al (2002) Limitations of MR imaging in the diagnosis of peripheral tears of the triangular fibrocartilage of the wrist. AJR Am J Roentgenol 178:419–422PubMedCrossRefGoogle Scholar
  69. 69.
    Nishikawa S, Toh S (2002) Anatomical study of the carpal attachment of the triangular fibrocartilage complex. J Bone Joint Surg Br 84:1062–1065PubMedCrossRefGoogle Scholar
  70. 70.
    Buck FM, Gheno R, Nico MA et al (2009) Ulnomeniscal homologue of the wrist: correlation of anatomic and MR imaging findings. Radiology 253:771–779PubMedCrossRefGoogle Scholar
  71. 71.
    Ishii S, Palmer AK, Werner FW et al (1998) An anatomic study of the ligamentous structure of the triangular fibrocartilage complex. J Hand Surg Am 23:977–985PubMedCrossRefGoogle Scholar
  72. 72.
    Nakamura T, Yabe Y, Horiuchi Y (1996) Functional anatomy of the triangular fibrocartilage complex. J Hand Surg Br 21:581–586PubMedCrossRefGoogle Scholar
  73. 73.
    Moritomo H (2013) Anatomy and clinical relevance of the ulnocarpal ligament. J Wrist Surg 2:186–189PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Totterman SM, Miller RJ (1995) Triangular fibrocartilage complex: normal appearance on coronal three-dimensional gradient-recalled-echo MR images. Radiology 195:521–527PubMedCrossRefGoogle Scholar
  75. 75.
    Theumann NH, Pfirrmann CW, Antonio GE et al (2003) Extrinsic carpal ligaments: normal MR arthrographic appearance in cadavers. Radiology 226:171–179PubMedCrossRefGoogle Scholar
  76. 76.
    Mayfield JK, Johnson RP, Kilcoyne RF (1976) The ligaments of the human wrist and their functional significance. Anat Rec 186:417–428PubMedCrossRefGoogle Scholar
  77. 77.
    Puri SK, Morse KW, Hearns KA, Carlson MG (2017) A biomechanical comparison of extensor carpi ulnaris subsheath reconstruction techniques. J Hand Surg Am 42(837):e1–e7Google Scholar
  78. 78.
    Taleisnik J, Gelberman RH, Miller BW, Szabo RM (1984) The extensor retinaculum of the wrist. J Hand Surg Am 9:495–501PubMedCrossRefGoogle Scholar
  79. 79.
    Graham TJ (2012) Pathologies of the extensor carpi ulnaris (ECU) tendon and its investments in the athlete. Hand Clin 28:345–356PubMedCrossRefGoogle Scholar
  80. 80.
    Jeantroux J, Becce F, Guerini H et al (2011) Athletic injuries of the extensor carpi ulnaris subsheath: MRI findings and utility of gadolinium-enhanced fat-saturated T1-weighted sequences with wrist pronation and supination. Eur Radiol 21:160–166PubMedCrossRefGoogle Scholar
  81. 81.
    Pope T, Bloem H, Beltran J et al (2014) Musculoskeletal imaging, 2nd edn. W.B. Saunders Co., Philadelphia, pp 189–206Google Scholar
  82. 82.
    Schmitt R, Froehner S, Coblenz G, Christopoulos G (2006) Carpal instability. Eur Radiol 16:2161–2178PubMedCrossRefGoogle Scholar
  83. 83.
    Shahabpour M, Van Overstraeten L, Ceuterick P et al (2012) Pathology of extrinsic ligaments: a pictorial essay. Semin Musculoskelet Radiol 16:115–128PubMedCrossRefGoogle Scholar
  84. 84.
    Timins ME, Jahnke JP, Krah SF (1995) MR imaging of the major carpal stabilizing ligaments: normal anatomy and clinical examples. Radiographics 15:575–587PubMedCrossRefGoogle Scholar
  85. 85.
    Moser T, Cardinal E, Dosch JC (2009) Partial versus partial-thickness tears of the scapholunate and lunatotriquetral ligaments. AJR Am J Roentgenol 193:W469PubMedCrossRefGoogle Scholar
  86. 86.
    Zimmermann R, Rudisch A, Fritz D et al (2007) MR imaging for the evaluation of accompanying injuries in cases of distal forearm fractures in children and adolescents. Handchir Mikrochir Plast Chir 39:60–67PubMedCrossRefGoogle Scholar
  87. 87.
    Abid A, Accadbled F, Kany J et al (2008) Ulnar styloid fracture in children: a retrospective study of 46 cases. J Pediatr Orthop B 17:15–19PubMedCrossRefGoogle Scholar
  88. 88.
    Farr S, Grill F, Ganger R et al (2012) Pathomorphologic findings of wrist arthroscopy in children and adolescents with chronic wrist pain. Arthroscopy 28:1634–1643PubMedCrossRefGoogle Scholar
  89. 89.
    Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 14:594–606PubMedCrossRefGoogle Scholar
  90. 90.
    Mikic ZD (1978) Age changes in the triangular fibrocartilage of the wrist joint. J Anat 126:367–384PubMedPubMedCentralGoogle Scholar
  91. 91.
    Farr S, Zechmann U, Ganger R, Girsch W (2015) Clinical experience with arthroscopically-assisted repair of peripheral triangular fibrocartilage complex tears in adolescents — technique and results. Int Orthop 39:1571–1577PubMedCrossRefGoogle Scholar
  92. 92.
    Moritomo H, Masatomi T, Murase T et al (2010) Open repair of foveal avulsion of the triangular fibrocartilage complex and comparison by types of injury mechanism. J Hand Surg Am 35:1955–1963PubMedCrossRefGoogle Scholar
  93. 93.
    Atzei A, Luchetti R, Braidotti F (2015) Arthroscopic foveal repair of the triangular fibrocartilage complex. J Wrist Surg 4:22–30PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Atzei A, Luchetti R (2011) Foveal TFCC tear classification and treatment. Hand Clin 27:263–272PubMedCrossRefGoogle Scholar
  95. 95.
    Squires JH, England E, Mehta K, Wissman RD (2014) The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna. AJR Am J Roentgenol 203:146–153PubMedCrossRefGoogle Scholar
  96. 96.
    Ringler MD, Murthy NS (2015) MR imaging of wrist ligaments. Magn Reson Imaging Clin N Am 23:367–391PubMedCrossRefGoogle Scholar
  97. 97.
    Tanaka T, Yoshioka H, Ueno T et al (2006) Comparison between high-resolution MRI with a microscopy coil and arthroscopy in triangular fibrocartilage complex injury. J Hand Surg Am 31:1308–1314PubMedCrossRefGoogle Scholar
  98. 98.
    Tay SC, Berger RA, Parker WL (2010) Longitudinal split tears of the ulnotriquetral ligament. Hand Clin 26:495–501PubMedCrossRefGoogle Scholar
  99. 99.
    Trumble T (2011) Radial side (1D) tears. Hand Clin 27:243–254PubMedCrossRefGoogle Scholar
  100. 100.
    Ramavath AL, Unnikrishnan PN, George HL et al (2017) Wrist arthroscopy in children and adolescent with chronic wrist pain: arthroscopic findings compared with MRI. J Pediatr Orthop 37:e321–e325PubMedCrossRefGoogle Scholar
  101. 101.
    Kannikeswaran N, Sethuraman U (2010) Lunate and perilunate dislocations. Pediatr Emerg Care 26:921–924PubMedCrossRefGoogle Scholar
  102. 102.
    Alt V, Gasnier J, Sicre G (2004) Injuries of the scapholunate ligament in children. J Pediatr Orthop B 13:326–329PubMedCrossRefGoogle Scholar
  103. 103.
    Paci GM, Yao J (2015) Surgical techniques for the treatment of carpal ligament injury in the athlete. Clin Sports Med 34:11–35PubMedCrossRefGoogle Scholar
  104. 104.
    Mayfield JK, Johnson RP, Kilcoyne RK (1980) Carpal dislocations: pathomechanics and progressive perilunar instability. J Hand Surg Am 5:226–241PubMedCrossRefGoogle Scholar
  105. 105.
    Viegas SF, Patterson RM, Peterson PD et al (1990) Ulnar-sided perilunate instability: an anatomic and biomechanic study. J Hand Surg Am 15:268–278PubMedCrossRefGoogle Scholar
  106. 106.
    Jansen I, De Smet L, Van Ransbeeck H (2003) Traumatic lunotriquetral rupture in a 10-year-old girl. J Pediatr Orthop B 12:200–201PubMedGoogle Scholar
  107. 107.
    Lindau TR (2016) The role of arthroscopy in carpal instability. J Hand Surg Eur Vol 41:35–47PubMedCrossRefGoogle Scholar
  108. 108.
    Anderson ML, Skinner JA, Felmlee JP et al (2008) Diagnostic comparison of 1.5 tesla and 3.0 tesla preoperative MRI of the wrist in patients with ulnar-sided wrist pain. J Hand Surg Am 33:1153–1159PubMedCrossRefGoogle Scholar
  109. 109.
    Spaans AJ, Minnen P, Prins HJ et al (2013) The value of 3.0-tesla MRI in diagnosing scapholunate ligament injury. J Wrist Surg 2:69–72PubMedPubMedCentralCrossRefGoogle Scholar
  110. 110.
    Haims AH, Schweitzer ME, Morrison WB et al (2003) Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology 227:701–707PubMedCrossRefGoogle Scholar
  111. 111.
    Morrell NT, Moyer A, Quinlan N, Shafritz AB (2017) Scapholunate and perilunate injuries in the athlete. Curr Rev Musculoskelet Med 10:45–52PubMedPubMedCentralCrossRefGoogle Scholar
  112. 112.
    Weiss AP, Sachar K, Glowacki KA (1997) Arthroscopic debridement alone for intercarpal ligament tears. J Hand Surg Am 22:344–349PubMedCrossRefGoogle Scholar
  113. 113.
    Earp BE, Waters PM, Wyzykowski RJ (2006) Arthroscopic treatment of partial scapholunate ligament tears in children with chronic wrist pain. J Bone Joint Surg Am 88:2448–2455PubMedCrossRefGoogle Scholar
  114. 114.
    Viegas SF, Patterson RM, Hokanson JA, Davis J (1993) Wrist anatomy: incidence, distribution, and correlation of anatomic variations, tears, and arthrosis. J Hand Surg Am 18:463–475PubMedCrossRefGoogle Scholar
  115. 115.
    Viegas SF, Patterson RM, Ward K (1995) Extrinsic wrist ligaments in the pathomechanics of ulnar translation instability. J Hand Surg Am 20:312–318PubMedCrossRefGoogle Scholar
  116. 116.
    Smith DK (1993) Volar carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 161:353–357PubMedCrossRefGoogle Scholar
  117. 117.
    Taneja AK, Bredella MA, Chang CY et al (2013) Extrinsic wrist ligaments: prevalence of injury by magnetic resonance imaging and association with intrinsic ligament tears. J Comput Assist Tomogr 37:783–789PubMedCrossRefGoogle Scholar
  118. 118.
    Mak WH, Szabo RM, Myo GK (2012) Assessment of volar radiocarpal ligaments: MR arthrographic and arthroscopic correlation. AJR Am J Roentgenol 198:423–427PubMedCrossRefGoogle Scholar
  119. 119.
    Ringler MD, Howe BM, Amrami KK et al (2013) Utility of magnetic resonance imaging for detection of longitudinal split tear of the ulnotriquetral ligament. J Hand Surg Am 38:1723–1727PubMedCrossRefGoogle Scholar
  120. 120.
    Scheck RJ, Romagnolo A, Hierner R et al (1999) The carpal ligaments in MR arthrography of the wrist: correlation with standard MRI and wrist arthroscopy. J Magn Reson Imaging 9:468–474PubMedCrossRefGoogle Scholar
  121. 121.
    Totterman SM, Miller R, Wasserman B et al (1993) Intrinsic and extrinsic carpal ligaments: evaluation by three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 160:117–123PubMedCrossRefGoogle Scholar
  122. 122.
    Zlatkin MB, Chao PC, Osterman AL et al (1989) Chronic wrist pain: evaluation with high-resolution MR imaging. Radiology 173:723–729PubMedCrossRefGoogle Scholar
  123. 123.
    Cornwall R (2010) The painful wrist in the pediatric athlete. J Pediatr Orthop 30:S13–S16CrossRefGoogle Scholar
  124. 124.
    Rettig AC (2004) Athletic injuries of the wrist and hand. Part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med 32:262–273PubMedCrossRefGoogle Scholar
  125. 125.
    VanHeest AE, Luger NM, House JH, Vener M (2007) Extensor retinaculum impingement in the athlete: a new diagnosis. Am J Sports Med 35:2126–2130PubMedCrossRefGoogle Scholar
  126. 126.
    Horii E, Garcia-Elias M, An KN et al (1991) A kinematic study of luno-triquetral dissociations. J Hand Surg Am 16:355–362PubMedCrossRefGoogle Scholar
  127. 127.
    Moritomo H, Viegas SF, Elder KW et al (2000) Scaphoid nonunions: a 3-dimensional analysis of patterns of deformity. J Hand Surg Am 25:520–528PubMedCrossRefGoogle Scholar
  128. 128.
    Berger RA, Landsmeer JM (1990) The palmar radiocarpal ligaments: a study of adult and fetal human wrist joints. J Hand Surg Am 15:847–854PubMedCrossRefGoogle Scholar
  129. 129.
    Slutsky DJ (2008) Incidence of dorsal radiocarpal ligament tears in the presence of other intercarpal derangements. Arthroscopy 24:526–533PubMedCrossRefGoogle Scholar
  130. 130.
    Davis KW (2010) Imaging pediatric sports injuries: upper extremity. Radiol Clin N Am 48:1199–1211PubMedCrossRefGoogle Scholar
  131. 131.
    Rogers LF, Poznanski AK (1994) Imaging of epiphyseal injuries. Radiology 191:297–308PubMedCrossRefGoogle Scholar
  132. 132.
    DiFiori JP, Puffer JC, Mandelbaum BR, Dorey F (1997) Distal radial growth plate injury and positive ulnar variance in nonelite gymnasts. Am J Sports Med 25:763–768PubMedCrossRefGoogle Scholar
  133. 133.
    Jaramillo D, Laor T, Zaleske DJ (1993) Indirect trauma to the growth plate: results of MR imaging after epiphyseal and metaphyseal injury in rabbits. Radiology 187:171–178PubMedCrossRefGoogle Scholar
  134. 134.
    Laor T, Hartman AL, Jaramillo D (1997) Local physeal widening on MR imaging: an incidental finding suggesting prior metaphyseal insult. Pediatr Radiol 27:654–662PubMedCrossRefGoogle Scholar
  135. 135.
    Dwek JR, Cardoso F, Chung CB (2009) MR imaging of overuse injuries in the skeletally immature gymnast: spectrum of soft-tissue and osseous lesions in the hand and wrist. Pediatr Radiol 39:1310–1316PubMedPubMedCentralCrossRefGoogle Scholar
  136. 136.
    Liebling MS, Berdon WE, Ruzal-Shapiro C et al (1995) Gymnast's wrist (pseudorickets growth plate abnormality) in adolescent athletes: findings on plain films and MR imaging. AJR Am J Roentgenol 164:157–159PubMedCrossRefGoogle Scholar
  137. 137.
    Cerezal L, del Pinal F, Abascal F et al (2002) Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics 22:105–121PubMedCrossRefGoogle Scholar
  138. 138.
    Cook PA, Yu JS, Wiand W et al (1996) Madelung deformity in skeletally immature patients: morphologic assessment using radiography, CT, and MRI. J Comput Assist Tomogr 20:505–511PubMedCrossRefGoogle Scholar
  139. 139.
    Ali S, Kaplan S, Kaufman T et al (2015) Madelung deformity and Madelung-type deformities: a review of the clinical and radiological characteristics. Pediatr Radiol 45:1856–1863PubMedCrossRefGoogle Scholar
  140. 140.
    Vickers D, Nielsen G (1992) Madelung deformity: surgical prophylaxis (physiolysis) during the late growth period by resection of the dyschondrosteosis lesion. J Hand Surg Br 17:401–407PubMedCrossRefGoogle Scholar
  141. 141.
    Kozin SH, Zlotolow DA (2015) Madelung deformity. J Hand Surg Am 40:2090–2098PubMedCrossRefGoogle Scholar
  142. 142.
    Harley BJ, Brown C, Cummings K et al (2006) Volar ligament release and distal radius dome osteotomy for correction of Madelung's deformity. J Hand Surg Am 31:1499–1506PubMedCrossRefGoogle Scholar
  143. 143.
    Imai Y, Miyake J, Okada K et al (2013) Cylindrical corrective osteotomy for Madelung deformity using a computer simulation: case report. J Hand Surg Am 38:1925–1932PubMedCrossRefGoogle Scholar
  144. 144.
    Landfried MJ, Stenclik M, Susi JG (1991) Variant of Galeazzi fracture-dislocation in children. J Pediatr Orthop 11:332–335PubMedCrossRefGoogle Scholar
  145. 145.
    Daruwalla JS (1979) A study of radioulnar movements following fractures of the forearm in children. Clin Orthop Relat Res 1979:114–120Google Scholar
  146. 146.
    Letts M, Rowhani N (1993) Galeazzi-equivalent injuries of the wrist in children. J Pediatr Orthop 13:561–566PubMedCrossRefGoogle Scholar
  147. 147.
    Cannata G, De Maio F, Mancini F, Ippolito E (2003) Physeal fractures of the distal radius and ulna: long-term prognosis. J Orthop Trauma 17:172–179PubMedCrossRefGoogle Scholar
  148. 148.
    Cha SM, Shin HD, Jeon JH (2016) Long-term results of Galeazzi-equivalent injuries in adolescents — open reduction and internal fixation of the ulna. J Pediatr Orthop B 25:174–182PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of Washington, Seattle Children’s HospitalSeattleUSA
  2. 2.Division of Pediatric RadiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Department of Radiology, College of Human Medicine, Helen DeVos Children’s Hospital, Advanced Radiology ServicesMichigan State UniversityGrand RapidsUSA
  4. 4.Department of RadiologyChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  5. 5.Department of Radiology, Monroe Carell Jr. Children’s HospitalVanderbilt UniversityNashvilleUSA

Personalised recommendations