A note on the radio-carpal articulation / by Francis J. Shepherd.

  • Francis Shepherd
Date:
[1891?]
Catalogue details

Licence: Public Domain Mark

Credit: A note on the radio-carpal articulation / by Francis J. Shepherd. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    If one looks at the upper surface of the semilunar, one will find that it is somewhat triangular in shape, the rounded angle of the apex of the triangle being toward the pyramidal bone, and continuous with its upper surface and the base towards the scaphoid. In the fresh state, when this surface of the semilunar bone is covered with cartilage, a distinct line may be seen separating the surface, articulating with the radius from that opposite the fibro-cartilage. This latter surface, from the examination of a number of subjects, I find varies considerably in size and extends more to the palmar than the dorsal surface. When the upper articular surface of the pyramidal bone is of large size, then the facet on the lunar bone opposing the meniscus is small, and vice versa. In some cases the upper surface of the pyramidal bone may not be in contact with the fibro-cartilage at all, except in extreme adduction; when this occurs there is a large surface of the semilunar bone in contact with the fibro-cartilage, the small articular facet on the pyra- midal being in contact with the capsule of the joint. In other cases the portion of semilunar bone opposite the meniscus is so small as hardly to be noticeable, consisting merely of a very narrow strip, a line or two wide, on the ulnar side of the upper articular surface. Years ago, not knowing what had been done by Henle, my attention was directed to this articulation of the lunar and pyramidal bones whilst investigating the frequency of perforation of the triangular fibro-cartilage. I frequently noticed that when there was a perforation of the meniscus it was due to some form of synovitis or arthritis, and that the sur- face of the carpus opposite the perforation was always a portion of the semilunar bone. When the opening was small this surface was dull, and did not glisten like the rest of the carti- lage ; later, as the opening ^vore larger and friction became greater, portions of the cartilage became roughened and loose; later still, the cartilage disappeared altogether leaving a spot of bare bone, which corresponded to the opening in the fibro- cartilage. If the process still went on, this bare bone became polished or eburnated as well as the lower end of the ulna, which went through the same changes, though not so rapidly. In such cases I was always struck by the fact that this roughened or eburnated surface was of larger extent on the semilunar than