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
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
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)
1st : Saddle
2nd-5th : 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 1st metacarpal
1st Carpometacarpal Joint

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

20. Investigation
X-RAY

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 Scaphoid
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

24. THANKYOU