The ulnotriquetral ligament is the most ulnar of the palmar ulnocarpal ligaments, running from the palmar radioulnar ligament of the TFCC, near the ulnar fovea, to the palmar surface of the triquetrum. With the ulnolunate ligament it forms the ulnar part of the palmar extrinsic wrist ligament system and is closely associated with the TFCC.
| Origin | Palmar radioulnar ligament of the TFCC, near the ulnar fovea |
|---|---|
| Insertion | Palmar surface of the triquetrum |
Stabilises the triquetrum and ulnar carpus, limits triquetral displacement during forearm rotation and ulnar deviation, and contributes to load transmission across the ulnocarpal joint.
Ulnotriquetral ligament tears can result from forced wrist extension with ulnar deviation, producing ulnar-sided wrist pain localised to the pisotriquetral and lunotriquetral area. It is often injured with the TFCC, and MRI arthrography can show tears near its ulnar attachment. The ligament is directly visualised during ulnar wrist arthroscopy. Chronic tears can contribute to ulnar carpal and lunotriquetral instability. Arthroscopic debridement or repair, sometimes with TFCC foveal repair, is chosen according to tear pattern and acuity.
Disruption of the ulnotriquetral and lunotriquetral ligaments allows abnormal triquetral motion, producing a clunking sensation with radial and ulnar deviation and a positive lunotriquetral shear (Reagan) test.
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