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Hand and Wrist

Hand and Wrist

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Hand and Wrist

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  1. Hand and Wrist

  2. Forearm Anatomy • Radius • Ulna • Carpal Bones • Metacarpals • Phalanges-Inter-phalageal joints(IP) are proximal and distal and the metacarpal-phalangeal joints are (MCP)

  3. Carpal Bones • Navicular (Scaphoid) “Anatomical Snuff Box” • Lunate • Triquetrium • Pisiform • Trapezium • Trapezoid • Capitate • Hamate

  4. Motions of the Hand • Flexion • Extension • Ulnar Deviation (Adduction) • Radial Deviation (Abduction) • Supination • Pronation

  5. 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

  6. 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

  7. Pronators and Supinators • Pronator Teres • Supinator Teres

  8. Muscles of the Forearm

  9. 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

  10. Colle’s Fracture

  11. 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

  12. Navicular Fracture

  13. Lunate Fracture • Carpal bone that commonly dislocates • Most common cause is falling on an outstretched arm and hand • Dislocation is forward and painful

  14. 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.

  15. 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 arm • Tingling numbness felt in the fingers • Weakness with flexion pain increases at night • Treatment is wrist splint or surgical intervention

  16. Ganglion Cyst • Tendon becomes inflammed sheath herniates causing a fluid filled sac • Surgical Excision

  17. Metacarpal Fracture • Boxers Fracture to 5th metacarpal • Compare domes of the knuckles while making a fist • Tends to heal rapidly

  18. Boxer’s Fracture

  19. Ligament Sprain • Tends to occur to the MP and IP joints • Joints are jammed and causes the capsule to swell

  20. Avulsion Fracture • Could be called “Mallet Finger” • Extensor Tendon torn with bone avulsion in some cases

  21. Bennett’s Fracture • This is where the extensor tendon pulls off the distal end of the thumb

  22. Dislocated Thumb • Never reduce this injury because of the high nerve supply. • MEDICAL EMERGENCY