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Transverse Retinacular Ligament

ligamentum retinaculare transversum

The transverse retinacular ligament (Landsmeer transverse ligament) is a short transverse fibrous band connecting the flexor sheath at the PIP joint level to the lateral bands of the extensor mechanism, preventing dorsal migration of the lateral bands. It acts as a stabiliser of the extensor mechanism, keeping the lateral bands in their correct lateral position relative to the PIP joint axis.

Region: Hand & Wrist

Biomechanics

Function & Actions

Prevents dorsal subluxation of the lateral extensor bands over the PIP joint, maintaining them in the lateral position where they contribute to both PIP extension and DIP extension without causing a swan-neck deformity.

Clinical Relevance

Clinical Notes

Disruption of the transverse retinacular ligament (from PIP synovitis in rheumatoid arthritis or direct trauma) allows the lateral bands to sublux dorsally over the PIP joint, producing a swan-neck deformity where the PIP hyperextends and the DIP flexes. Conversely, swan-neck correction involves reconstructing or tightening the transverse retinacular ligament to keep the lateral bands laterally and restore the normal PIP joint moment arm.

Pathology

Common Injuries & Conditions

Swan-Neck Deformity from Lateral Band Subluxation

Laxity or rupture of the transverse retinacular ligament allows the lateral bands to sublux dorsally over the PIP joint in rheumatoid or post-traumatic fingers, producing PIP hyperextension and DIP flexion (swan-neck), treated by lateral band relocation and transverse retinacular ligament reconstruction.