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Metacarpophalangeal Joint

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Introduction

Illustration of the metacarpophalangeal joint[1]
natomy of the metacarpophalangeal joint from the ulnar side. 1: proximal phalanx, 2: first metacarpal, 3: UCL, 4: AUCL, 5: palmar proximal ligament, 6: volar, 7: aponeurosis of the adductor, 8: adductor pollicis muscle, 9: sesamoid ulnar bone, 10: extensor tendon, and 11: abductor tendon of the thumb.[2]
Anatomical drawing of the metacarpophalangeal joint: a) longitudinal aspect; b) transversal aspect at level of the proximal phalanx base. MC -metacarpal bone, PP -proximal phalanx, E -extensor tendon, F -flexor tendons (superficial and profound) in the synovial sheath, L -lumbrical tendon, I -interosseous tendon, S -sagittal band, MCL -main collateral ligament, ACL -accessory collateral ligament, DLT -deep transverse metacarpal ligament, black arrow -dorsal plate, white arrowpalmar (volar) plate.[3]

Alternative Names

  • MCPJ
  • Knuckle Joint
  • Finger Knuckle Joint
  • Metacarpal Phalangeal Joint
  • Metacarpophalangeal Articulation
  • Digital Knuckle Joint
  • Finger MCP Joint

General

Anatomic Description

  • Metacarpal head: asymmetric in coronal, sagittal planes
  • Articular surface forms a condyloid joint with the shallow, concave proximal phalanx

Capsule

  • Extends from the metacarpal neck to the base of the proximal phalanx
  • Reinforced by ligamentous structures on all sides (see below)

Stabilizing Structures and Actions

  • Proper Collateral Ligaments
    • Origination: dorsal aspect of metacarpal head
    • Insertion: volar aspect of base of proximal phalanx
    • Function: Primary stabilizer of MCPJ, most stability provided during flexion[4]
  • Accessory Collateral Ligaments
    • Origination: volar to the proper collateral ligaments
    • Insertion: volar plate
    • Function: Provide stability in flexion
  • Volar Plate
    • Function: stabilizes the volar aspect of MCP joint, allows hyperextension of MCPJ
    • Thick fibrocartilaginous portion distally, loose membranous portion proximally
    • Proximal portion does facilitate some hyperextension of the MCPJ[5]
  • Dorsal Capsule
    • Function: weak stabilizer of the dorsal aspect of MCP joint
    • Capsule is thin and loose here, most vulnerable
    • Extrinsic extensor tendons are supported by the sagittal band of the extensor hood
  • Sagittal Bands
    • Origination: from the extensor hood
    • Insertion: attaches volarly with transverse metacarpal ligament
    • Function: supports the extrinsic tendons

Movement

  • Multiplanar: flexion, extension, abduction, adduction, and circumduction
  • Enabled by complex shape of metacarpal head, articular surface, supporting soft tissue structures
  • Total range of motion of MCPJ is greater than that of the proximal and distal interphalangeal joints

Thumb MCP Joint

  • Similar to the MCP Joint of other ringers with the following exceptions
  • More hinge-like than multi-axial
  • Sesamoid Bones lie anterior to the metacarpal head, articulate with it
  • Stabilized by similar ligament complex
  • Stability is necessary to facility pinch and grasp

Vascular Supply

  • Branches of the interdigital arteries

Nerve

  • Branches of the interdigital nerves

Clinical Significance


See Also


Reference

  1. Image courtesy of teachmenanatomy.info, "metacarpophalangeal"
  2. Cagnolati, Amanda Favaro, et al. "Ultrasonographic characterization of the ulnar collateral ligament of normal thumbs in different age groups." Clinics 73 (2018): e162.
  3. Fodor, Daniela, et al. "Ultrasonography of the metacarpophalangeal joints in healthy subjects using an 18 MHz transducer." Medical Ultrasonography 17.2 (2015): 185-191.
  4. Minami, Akio, et al. "Ligament stability of the metacarpophalangeal joint: a biomechanical study." The Journal of hand surgery 10.2 (1985): 255-260.
  5. Zemel, Norman P. "Metacarpophalangeal joint injuries in fingers." Hand clinics 8.4 (1992): 745-754.
Created by:
John Kiel on 16 August 2019 00:42:15
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Last edited:
10 May 2026 22:30:46
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