The deep transverse metacarpal ligaments are three short, strong bands that connect the palmar plates of the metacarpophalangeal (knuckle) joints of the index, middle, ring and little fingers to one another. They hold the heads of these four metacarpals together while still allowing the arch of the hand to flex. The thumb is not linked in this way, which leaves it free to move independently. The tendons of the interossei pass behind (dorsal to) the ligaments, while the lumbricals and digital nerves and arteries pass in front (palmar to) them.
| Origin | Palmar plate of the metacarpophalangeal joint of the index, middle and ring fingers |
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| Insertion | Palmar plate of the adjacent metacarpophalangeal joint (linking the index to little finger MCP joints) |
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Binds the metacarpal heads of the four fingers into a stable but flexible transverse arch and prevents them separating under load.
These ligaments explain why isolated fractures of the middle and ring metacarpal shafts usually shorten very little: the intact ligaments on each side tether the metacarpal head. Border metacarpals (index and little finger) are attached on only one side and can shorten or rotate more. In ray amputation of a central finger, the deep transverse metacarpal ligaments of the neighbouring rays are often repaired to close the gap and prevent scissoring of the fingers.
A fracture of a metacarpal shaft that shortens or rotates; shortening is limited in the middle and ring fingers by the intact deep transverse metacarpal ligaments but can be greater in the border digits.
Crossing or gapping of the remaining fingers after removal of a central finger ray, prevented by repairing the deep transverse metacarpal ligaments of the adjacent rays.
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