Anatomy of the Ulnocarpal Compartment

  • Hisao Moritomo
  • Toshiyuki Kataoka


The form of the ulnar side of the human wrist represents progressive evolutionary development. In prosimians, the ulna continued to articulate with the pisiform and triquetrum, aiding in weight transmission across the wrist [1]. The monkey wrist showed the first step to change from the weight-bearing wrist to the mobile wrist (Fig. 1.1). In the gibbon, the ulna has migrated proximally and does not articulate directly with the pisiform and triquetrum. Instead, a thick meniscus was interposed between these three bones [1]. Chimpanzees developed a wrist that was similar to humans. There is a formal distal radioulnar joint that is bounded distally by the triangular fibrocartilage (TFC). In addition, a blind recess or prestyloid recess develops [1]. Humans have wrists characterized by further withdrawal of the ulnar styloid with loss of the articular cartilage from the ulnar styloid [2]. In addition, the distal ulna has evolved to allow greater pronosupination. The embryologic and clinical material suggests there is a tremendous variation in the development of the ulnar side of the wrist. The data also support the concept that evolution continues and that we are all different in terms of our ulnocarpal and distal radioulnar joints. Different configurations may require careful consideration before applying singular solutions to such a complex area [3].


Ulnar Nerve Wrist Extension Ulnar Styloid Distal Radioulnar Joint Extensor Carpus Ulnaris 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Lewis OJ, Hamshere RJ, Bucknill TM (1970) The anatomy of the wrist joint. J Anat 106(Pt 3):539–552PubMedGoogle Scholar
  2. 2.
    Lewis OJ (1974) The wrist articulations of the anthropoidea. Academic, New York, pp 143–169Google Scholar
  3. 3.
    Louis DS, Jebson PJ (1998) The evolution of the ­distal radio-ulnar joint. Hand Clin 14(2):155–159PubMedGoogle Scholar
  4. 4.
    Short WH (2004) Triangular fibrocartilage complex injuries and ulnar impaction syndrome. In: Berger RA, Weiss APC (eds) Hand surgery, vol 1. Lippincott Williams & Wilkins, Philadelphia, pp 355–380Google Scholar
  5. 5.
    Berger RA (1997) The ligaments of the wrist. A ­current overview of anatomy with considerations of their potential functions. Hand Clin 13(1):63–82PubMedGoogle Scholar
  6. 6.
    Garcia-Elias M (1998) Soft-tissue anatomy and relationships about the distal ulna. Hand Clin 14(2):165–176PubMedGoogle Scholar
  7. 7.
    Ishii S et al (1998) An anatomic study of the ligamentous structure of the triangular fibrocartilage complex. J Hand Surg 23(6):977–985CrossRefGoogle Scholar
  8. 8.
    Lewis OJ (1972) Osteological features characterizing the wrists of monkeys and apes, with a ­reconsideration of this region in Dryopithecus (Proconsul) africanus. Am J Phys Anthropol 36(1):45–58PubMedCrossRefGoogle Scholar
  9. 9.
    Garcia-Elias M, Domenech-Mateu JM (1987) The articular disc of the wrist. Limits and relations. Acta Anat (Basel) 128(1):51–54CrossRefGoogle Scholar
  10. 10.
    Mikic ZD (1989) Detailed anatomy of the articular disc of the distal radioulnar joint. Clin Orthop Relat Res 245:123–132PubMedGoogle Scholar
  11. 11.
    Bowers WH (1993) The distal radioulnar joint. In: Green DP (ed) Operative hand surgery, vol 1, 3rd edn. Churchill Livingstone, New York, pp 973–1019Google Scholar
  12. 12.
    Taleisnik J (1985) The ligaments of the wrist. The wrist. Churchill Livingstone, New York, pp 13–38Google Scholar
  13. 13.
    Palmer AK, Werner FW (1981) The triangular fibrocartilage complex of the wrist – anatomy and function. J Hand Surg Am 6(2):153–162PubMedGoogle Scholar
  14. 14.
    Kauer JM (1975) The articular disc of the hand. Acta Anat (Basel) 93(4):590–605CrossRefGoogle Scholar
  15. 15.
    Bednar MS, Arnoczky SP, Weiland AJ (1991) The microvasculature of the triangular fibrocartilage complex: its clinical significance. J Hand Surg Am 16(6):1101–1105PubMedCrossRefGoogle Scholar
  16. 16.
    Chidgey LK (1991) Histologic anatomy of the triangular fibrocartilage. Hand Clin 7(2):249–262PubMedGoogle Scholar
  17. 17.
    Mikic ZD (1984) Arthrography of the wrist joint. An experimental study. J Bone Joint Surg Am 66(3):371–378PubMedGoogle Scholar
  18. 18.
    Nakamura T, Yabe Y, Horiuchi Y (1996) Functional anatomy of the triangular fibrocartilage complex. J Hand Surg Br 21(5):581–586PubMedCrossRefGoogle Scholar
  19. 19.
    Kleinman WB, Graham TJ (1998) The distal radioulnar joint capsule: clinical anatomy and role in posttraumatic limitation of forearm rotation. J Hand Surg Am 23(4):588–599PubMedCrossRefGoogle Scholar
  20. 20.
    Polatsch DB et al (2007) Ulnar nerve anatomy. Hand Clin 23(3):283–289PubMedCrossRefGoogle Scholar
  21. 21.
    Tindall A et al (2006) The anatomy of the dorsal cutaneous branch of the ulnar nerve – a safe zone for positioning of the 6R portal in wrist arthroscopy. J Hand Surg Br 31(2):203–205PubMedGoogle Scholar
  22. 22.
    Botte MJ et al (1990) The dorsal branch of the ulnar nerve: an anatomic study. J Hand Surg Am 15(4):603–607PubMedCrossRefGoogle Scholar
  23. 23.
    Lourie GM, King J, Kleinman WB (1994) The transverse radioulnar branch from the dorsal sensory ulnar nerve: its clinical and anatomical significance further defined. J Hand Surg Am 19(2):241–245PubMedCrossRefGoogle Scholar
  24. 24.
    Hankins CL, Flemming S (2005) A variant of Kaplan’s accessory branch of the dorsal cutaneous branch of the ulnar nerve: a case report and review of the literature. J Hand Surg Am 30(6):1231–1235PubMedCrossRefGoogle Scholar
  25. 25.
    Hoogbergen MM, Kauer JM (1992) An unusual ulnar nerve-median nerve communicating branch. J Anat 181(Pt 3):513–516PubMedGoogle Scholar
  26. 26.
    Kaplan EB (1963) Variation of the ulnar nerve at the wrist. Bull Hosp Joint Dis 24:85–88PubMedGoogle Scholar
  27. 27.
    McCarthy RE, Nalebuff EA (1980) Anomalous volar branch of the dorsal cutaneous ulnar nerve: a case report. J Hand Surg Am 5(1):19–20PubMedGoogle Scholar
  28. 28.
    Goto A et al (2010) The dorsal cutaneous branch of the ulnar nerve: an anatomical study. Hand Surg 15(3):165–168PubMedCrossRefGoogle Scholar
  29. 29.
    Moritomo H, Masatomi T, Murase T, Tanaka H, Miyake J, Yoshikawa H (2010) Open repair of foveal avulsion of the triangular fibrocartilage complex and comparison by types of injury mechanism. J Hand Surg 35A:1955–1963Google Scholar
  30. 30.
    Hagert CG (1996) Current concepts of the functional anatomy of the distal radioulnar joint, including the ulnocarpal junction. Wrist instability. Martin Dunitz, London, pp 15–21Google Scholar
  31. 31.
    Weaver L, Tencer AF, Trumble TE (1994) Tensions in the palmar ligaments of the wrist. I. The normal wrist. J Hand Surg Am 19(3):464–474PubMedCrossRefGoogle Scholar
  32. 32.
    Ritt MJ et al (1995) Rotational stability of the carpus relative to the forearm. J Hand Surg Am 20(2):305–311PubMedCrossRefGoogle Scholar
  33. 33.
    Wiesner L et al (1996) Experimentally induced ­ulno-carpal instability. A study on 13 cadaver wrists. J Hand Surg Br 21(1):24–29PubMedGoogle Scholar
  34. 34.
    Moritomo H et al (2008) Change in the length of the ulnocarpal ligaments during radiocarpal motion: ­possible impact on triangular fibrocartilage complex foveal tears. J Hand Surg Am 33(8):1278–1286PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Physical TherapyOsaka Yukioka college of Health ScienceIbaragi-shi, OsakaJapan
  2. 2.Department of OrthopaedicsGraduate School of Medicine, Osaka UniversitySuita-shi, OsakaJapan

Personalised recommendations