HAND AND WRIST

FOREARM ANATOMY Radius

Ulna

Carpal Bones

Metacarpals

Phalanges-Inter-phalageal joints(IP) are proximal and distal and the metacarpal-phalangeal joints are (MCP)

CARPAL BONES

Navicular (Scaphoid) “Anatomical Snuff Box”

LunateTriquetriumPisiformTrapeziumTrapezoidCapitate Hamate

MOTIONS OF THE HAND

Flexion

Extension

Ulnar Deviation (Adduction)

Radial Deviation (Abduction)

Supination

Pronation

MUSCLES OF THE HAND (FLEXORS)

Flexor Carpi Ulnaris- flexes wrist and fingers

Flexor Carpi Radialis- flexes wrist and fingers

Flexor Policis Longus- flexes thumb

Palmaris Longus- flexes fingers

MUSCLES OF THE HAND (EXTENSORS)

Extensor Carpi Ulnaris- extends wrist and fingers

Extensor Carpi Radialis- extends wrist and fingers

Extensor Digitorum Longus- estends fingers

Extensor Digiti Minimi- extends pinky finger

PRONATORS AND SUPINATORS

Pronator Teres

Supinator Teres

MUSCLES OF THE FOREARM

INJURIES TO THE WRIST AND HAND Forearm Splints

Interosseus membrane between radius and ulna stretches, retinaculum may also be injured.

Wrist Fracture

Colles fracture: to distal end of the radius and/or ulna. Anytime the wrist is injured an x-ray is needed. Radiating pain up the arm and shaft of the humerus is a reason to x-ray along with pain in the anatomical snuff box. With a Colles fx there is pain with flexion and radial deviation and supination is impossible

COLLE’S FRACTURE

NAVICULAR FRACTURE

Highest no-union rate of all the bones in the wrist

Highest fracture rate of all the bones in the wrist

Blood supply is limited so the healing process is lengthened sometimes never heals without aid

NAVICULAR FRACTURE

LUNATE FRACTURE

Carpal bone that commonly dislocates

Most common cause is falling on an outstretched arm and hand

Dislocation is forward and painful

GAMEKEEPERS THUMB

This is a sprain or avulsion of the ulnar collateral ligament on the thumb.

Can be braced for healing or sometimes needs surgical intervention.

CARPAL TUNNEL SYNDROME

Tendons become inflammed and the swelling puts pressure on the nerves

Causes pain and malfunction of the hand

Pain can radiate up the armTingling numbness felt in the

fingersWeakness with flexion pain

increases at nightTreatment is wrist splint or

surgical intervention

GANGLION CYST

Tendon becomes inflammed sheath herniates causing a fluid filled sac

Surgical Excision

METACARPAL FRACTURE

Boxers Fracture to 5th metacarpal

Compare domes of the knuckles while making a fist

Tends to heal rapidly

BOXER’S FRACTURE

LIGAMENT SPRAIN

Tends to occur to the MP and IP joints

Joints are jammed and causes the capsule to swell

AVULSION FRACTURE

Could be called “Mallet Finger”

Extensor Tendon torn with bone avulsion in some cases

BENNETT’S FRACTURE

This is where the extensor tendon pulls off the distal end of the thumb

DISLOCATED THUMB

Never reduce this injury because of the high nerve supply.

MEDICAL EMERGENCY