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FIG. 94. The central figure is a schematic analysis of the structure of the metacarpo-phalangeal joints a 

 seen on transverse section. The plane of the transverse metacarpal ligament lies between the capsul 

 and the tendons of the flexors of the digits and Lumbricals. The expansion of the tendon of Palmaris 

 longus which forms the palmar fascia covers the flexor tendons, and in the lower part of the hand sends 

 in fibres between the tendons to reach the metacarpal shafts and transverse metacarpal ligament. 

 Thus the tendons are in a kind of incomplete compartment before they enter the proper theca of each 

 finger. The Lumbricals pass down between the tendons, in front of the ligament, which separates 

 them from the tendons of the Interossei. On the right the relation of these structures to the theca 

 is shown in two fingers ; observe that the fibres from the palmar fascia extend down as far as the base 

 of the second phalanx, a detail which explains the flexion of the two proximal phalanges found in 

 pathological contraction of the fascia. On the left is the head of a metacarpal bone, with the synovial 

 and ligamentous areas shown upon it. Below this the metacarpo-phalangeal joint is figured, the 

 transverse ligament not being represented ; notice the direction of the lateral and front fibres, and the 

 expansion of the extensor tendon which covers the joint behind and postero-laterally. 



