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Wrist Midcarpal Joint

articulatio mediocarpalis

The midcarpal joint separates the proximal and distal carpal rows and contributes substantially to wrist flexion while being less important for extension. The proximal row acts as an intercalated segment between the radius and distal row, its position determined by the forces applied through the scaphoid and triquetrum. Disruption of the scapholunate or lunotriquetral ligaments alters the normal kinematics of the proximal row through the midcarpal joint, producing the DISI and VISI instability patterns.

Region: Hand & Wrist

Clinical Relevance

Clinical Notes

Midcarpal instability from palmar midcarpal ligament laxity produces the painful catch-up clunk during ulnar deviation when the proximal row suddenly translates from flexion to extension. The clunk is reproduced by the catch-up clunk test during ulnar deviation under load. Conservative management with wrist strengthening usually fails, and arthroscopic dorsal capsulodesis or palmar ligament augmentation is required for symptomatic cases.

Pathology

Common Injuries & Conditions

Midcarpal Instability

Palmar ligament laxity producing catch-up clunk during loaded ulnar deviation, managed with proprioceptive training before considering arthroscopic capsulodesis.