Wrist joint

Anatomy of wrist joint and small joints of hand

1. Wrist Joint & Joints of Hand

2. Wrist Joint SYNONYMN RADIO CARPAL JOINT Type : Synovial joint Sub type: Ellipsoid variety Biaxial Wrist complex Radiocarpal joint Midcarpal joint

3. Above : Distal end of the radius Articular disc of inferior RU joint Below : Scaphoid, Lunate, and Triquetral bones The proximal articular surface forms an ellipsoid concave surface, in which fits the distal ellipsoid convex surface. Articulating Surfaces

4. Capsular ligament Palmar ligaments Dorsal ligament Collateral ligaments Ligaments

5. Encloses the joint and is attached above to the distal ends of the radius and ulna and below to the proximal row of carpal bones. Capsular ligament

6. Lines the capsule and is attached to the margins of the articular surfaces. The joint cavity does not communicates with that of the distal radio-ulnar joint or with the joint cavities of the intercarpal joints. Prestyloid recess Synovial Membrane

7. Palmar radiocarpal Ligament Palmar ulnocarpal Ligament Dorsal radiocarpal Ligament Radial collateral ligament Ulnar collateral ligament Ligaments

8. Anteriorly : tendons of Flexor digitorum superficialis Flexor digitorum profundus Flexor pollicis longus Flexor carpi radialis Flexor carpi ulnaris Median and ulnar nerves Laterally: Radial artery Relations

9. Posteriorly : Tendons of Abductor Pollicis Longus Extensor Pollicis Brevis Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Extensor Pollicis Longus Extensor Indicis Extensor Digitorum Extensor Digiti Minimi Extensor Carpi Ulnaris Relations

10. Blood Supply : Ant & Post carpal arches formed by branches of radial and ulnar arteries Nerve supply: Anterior & posterior interosseous nerves Blood & Nerve Supply

11. Movements

12. Flexion: Mainly at midcarpal joint Range-0-60 degrees Muscles : Flexor Carpi Radialis Flexor Carpi Ulnaris Palmaris Longus. Assisted by: Flexor Digitorum Superficialis Flexor Digitorum Profundus Flexor Pollicis Longus. Movements

13. Extension: Mainly at wrist joint Range-0-50 degrees Muscles: Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Extensor Carpi Ulnaris Assisted by: Extensor Digitorum Extensor Indicis Extensor Digiti Minimi Extensor Pollicis Longus Movements

14. Abduction : At Midcarpal joint Range:0-15 degrees Muscles : Flexor Carpi Radialis Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Assisted by: Abductor Pollicis Longus Extensor Pollicis Longus Extensor Pollicis Brevis Movements

15. Adduction: Mainly at wrist joint Range:0-50 degree Muscles: Flexor Carpi Ulnaris Extensor Carpi Ulnaris Circumduction: Combination of flexion adduction, extension and abduction Movements

16. Mid Carpal Joint Ellipsoid joint Articulation between proximal and distal carpal rows Intercarpal Joints Plane synovial joints Between individual carpal bones of proximal row and individual carpal bones of distal row. Joints of Hand

17. Carpometacarpal Joints (CMC) 1 st : Saddle 2 nd -5 th : Plane joints Intermetacarpal Joints Plane joints Metacarpophalangeal joints Ellipsoid joints Interphalangeal joints Hinge joints Joints of Hand

18. Type : Saddle variety of synovial joint Articulating surfaces : Proximal: distal surface of trapezium Distal: Proximal surface of base of 1 st metacarpal 1st Carpometacarpal Joint

19. Ligaments Capsular ligament Ant ligament Post ligaments Lateral ligament Relations Movements Applied Anatomy De Quervains Tenosynovitis 1st Carpometacarpal Joint

20. Investigation

21. Rheumatoid Arthritis Ganglion Aspiration done from posterior surface between tendons of EPL and EI. Immobilized in optimum position of 30 degrees(dorsiflexion) Clinical Anatomy

22. Fracture of the Scap hoid Cause : Fall on an outstretched hand Sign/Symptoms : tenderness in the anatomical snuffbox Complications : Avascular necrosis Arthritis Clinical Anatomy

23. Colle”s Fracture: Fracture of lower end of radius Distal fragment is displaced posteriorly Cause : Fall on an outstretched hand Signs : Dinner fork deformity Clinical Anatomy

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