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.
| Origin | Flexor tendon sheath and palmar plate at the PIP joint |
|---|---|
| Insertion | Lateral border of the lateral band of the extensor mechanism |
Stabilises the lateral bands of the extensor mechanism at the PIP joint, preventing their dorsal migration so that they continue to extend both the PIP and DIP joints without causing a swan-neck deformity. It works with the oblique retinacular ligament to coordinate PIP and DIP motion.
Disruption or laxity 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. Swan-neck correction may involve relocating the lateral bands and reconstructing or tightening this ligament. In chronic boutonniere deformity the opposite occurs: the lateral bands slip palmar to the PIP axis and the transverse retinacular ligament contracts and holds them there, so its release is part of surgical correction.
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, treated by lateral band relocation and ligament reconstruction.
Secondary tightening of the ligament holds the palmarly displaced lateral bands in place, and it must be released to mobilise them back dorsally.
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