The deep transverse metacarpal ligament (DTML) passes across the anterior surfaces of the index to little finger metacarpal heads. It blends with the volar plates of the metacarpophalangeal joints (MCPJs) and maintains the transverse metacarpal arch. The relative positioning of the metacarpal heads is important for satisfactory function of the hand (Al-Qattan and Robertson, 1993). A 34-year-old female patient presented with a hyper-mobile ring finger metacarpal head that sub-luxed volarly secondary to a closed injury to the hand several years previously. This caused her significant pain with some activities, most notably when grasping objects.
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