Wrist and Hand Fractures

Published on 16/04/2015 by admin

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Last modified 16/04/2015

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23 Wrist and Hand Fractures

Anatomy of the Wrist and Hand

image

Carpal Bones

image

Bones of Wrist and Hand

Carpal Bones: Lateral to Medial

• Proximal

image Scaphoid, lunate, triquetrum, pisiform

• Distal

image Trapezium, trapezoid, capitate, hamate

Metacarpals

• Numbered I/1 (thumb) to V/5 (digiti minimi)
• Parts: base, shaft, head
• Shafts triangular in cross section
• V/5 most commonly fractured metacarpal

Phalanges

• Proximal, middle, distal (3) in each finger
• Proximal, distal (2) in thumb
• Parts: base, shaft, tuberosity (in distal phalanges), head
• Distal phalanx 3 common fracture

Joints of Wrist and Hand

• Radiocarpal (RC) joint

image Synovial joint between distal radius and articular disc (concave) and scaphoid, lunate, and triquetrum (convex)
image Allows movement around 2 axes: flexion/extension, adduction/abduction (ulnar and radial deviation, respectively)

• Carpal joints

image Synovial joints between carpals
image Share common joint cavity
image Limited movement contributes to positioning of hand, grasp

• Carpometacarpal (CM) joints

image Synovial, between distal row of carpal bones and 5 metacarpal bases
image Saddle joint between trapezium and thumb metatarsal more mobile than others: flex/extend, abduct/adduct, rotate, circumduct
image CM joints II-V

image Synovial arthrodial/gliding
image Range of movement increases medially: metacarpal 5 greatest.

image Joint capsules reinforced by palmar and dorsal ligaments and medial and lateral collateral ligaments

• Metacarpophalangeal (MCP) joints

image Synovial condylar
image Between metacarpal heads and proximal phalanges
image Joint capsules reinforced by palmar ligaments and medial and lateral collateral ligaments

• Interphalangeal joints

image Synovial hinge
image Supported by palmar and medial, lateral collateral ligaments

Ligaments of Wrist and Hand

• Supporting wrist (RC) joint: palmar radiocarpal, palmar ulnocarpal, dorsal radiocarpal ligaments
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