Carpal tunnel syndrome of the thumb, and the hamate hook that can be palpated along the axis of the ring finger. From the anatomical position, the carpal tunnel is bordered on the anterior surface by the transverse carpal ligament, also known as the flexor retinaculum. The flexor retinaculum is a strong, fibrous band that attaches to the pisiform and the hamulus of the hamate. The proximal boundary is the distal wrist skin crease, and the distal boundary is approximated by a line known as Kaplan's cardinal line. This line uses surface landmarks, and is drawn between the apex of the skin fold between
Carpal bones or "distal surfaces" are articular, the superior generally convex, the inferior concave; the "medial" and "lateral surfaces" are also articular where they are in contact with contiguous bones, otherwise they are rough and tuberculated. The structure in all is similar: cancellous tissue enclosed in a layer of compact bone. Occasionally accessory bones are found in the carpus, but of more than 20 such described bones, only four (the central, styloid, secondary trapezoid, and secondary pisiform bones) are considered to be proven accessory bones. Sometimes the scaphoid, triquetrum, and pisiform bones are divided into two. The carpal bones are ossified endochondrally