The deep transverse metacarpal ligament connects the volar plates of the index to little finger MCP joints, maintaining the transverse palmar arch and preventing splaying of the metacarpal heads. The digital neurovascular bundles to the fingers pass on either side of this ligament. In rheumatoid arthritis, laxity of this ligament allows metacarpal head splaying.
| Origin | Palmar plates of the index through little finger MCP joints |
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| Insertion | Connecting the volar plates of adjacent MCP joints transversely |
| Actions | Prevents divergence of the metacarpal heads; stabilises the transverse arch of the hand |
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The deep transverse metacarpal ligament is the anatomical structure responsible for the Dupuytren disease web space contracture when the natatory ligament (its extension into the webspace) is involved. The digital nerves run both dorsal and palmar to this ligament at different levels, a critical anatomical relationship in Dupuytren fasciectomy.
Deep transverse metacarpal ligament laxity from rheumatoid disease producing metacarpal head splaying and transverse arch flattening.
