The capitohamate ligament is an intrinsic intercarpal ligament connecting the lateral surface of the hamate to the medial surface of the capitate within the distal carpal row. It is one of the strongest intrinsic carpal ligaments, binding the distal row into a rigid functional unit during grip and power activities.
Maintains the cohesion of the distal carpal row, preventing relative motion between the capitate and hamate. This rigidity of the distal row is essential for transmitting grip force through the wrist from the metacarpals to the radius and ulna.
The capitohamate articulation is disrupted in axial carpal injuries, particularly in the radial column (axial-radial) or ulnar column (axial-ulnar) patterns from high-energy crush or blast mechanisms. The hamate hook, adjacent to this ligament, is the most commonly fractured carpal bone in racquet sport athletes from direct grip trauma. The capitohamate joint line is also one of the secondary fusion sites in wrist arthrodesis procedures for post-traumatic wrist arthrosis.
High-energy crush injury disrupts the capitohamate and adjacent ligaments, producing divergent or convergent dislocation of the carpal rays, requiring open reduction and complex ligament reconstruction.
A direct blow to the hypothenar eminence, common in golfers and racquet sport players, fractures the hamate hook adjacent to the capitohamate joint, producing ulnar wrist pain and weakened grip, diagnosed by CT and treated with fragment excision.
