The dorsal radiotriquetral ligament is the principal dorsal radiocarpal ligament, running obliquely from the dorsal margin of the distal radius to the dorsal surface of the triquetrum. It is a broad, strong band that crosses the dorsal wrist obliquely and is the primary dorsal stabiliser of the carpus, resisting flexion and ulnar translation of the proximal carpal row.
Restrains dorsal carpal subluxation, resists excessive ulnar translation of the carpus on the radius, and guides the helical screw-home motion of the proximal carpal row during wrist radial and ulnar deviation.
The dorsal radiotriquetral ligament is the key structure repaired during dorsal radiocarpal ligament reconstruction procedures for carpal instability with ulnar translation. It is assessed during wrist arthroscopy from the radiocarpal space and can be distinguished from the shorter dorsal intercarpal ligament that runs between the triquetrum and scaphoid in the proximal carpal row. Surgical approaches to the distal radius must carefully reattach or repair this ligament to maintain carpal stability.
Forced wrist flexion or ulnar deviation can stretch or tear the dorsal radiotriquetral ligament, producing dorsal wrist pain, loss of grip strength, and a positive dorsal radiocarpal stress test, often managed with splinting and physiotherapy but requiring arthroscopic assessment in persistent cases.
Attritional failure of the dorsal radiotriquetral ligament in inflammatory arthritis allows the entire carpus to migrate ulnarly on the radius, producing a characteristic deformity and requiring ligament reconstruction or radiocarpal fusion.
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