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SANJAY KUMAR YADAV
LECTURER
KMCTH
Articulation
Radial head and osseo-fibrous ring
Annular ligament and radial notch of the ulna
1/5th
Osseo-fibrous ring & 4/5th
by annular ligament
Superior radio-ulnar joint
Contd….
Annular ligament is strong fibrous band
Attached to the anterior and posterior margin of radial
notch
Upper border continuous with fibrous capsule
•Inferiorly, few fibers from lower margin of annular ligament passes
over the synovial membrane and attached to the neck of radius
•Thin fibrous ligament called quadrate ligament stretches between
the neck of the radius and the upper part of supinator fossa of ulnar
and closes joint cavity from below, between radius and ulna
•Externally blends with the radial collateral ligament
Applied anatomy
Nursemaid’s Elbow
Subluxation of joint
1-5 year of age
Girls- 20%
Contd….
• Blood supply: articular
branches derived from the
anastomoses around the
elbow joint
• Nerve supply: small
branches from the
musculocutaneous,
median, radial and ulnar
nerves
• Hilton’s Law
Distal radioulnal joint
Pivot joint
Head of ulna & ulnar notch of radius
Synovial membrane extremely loose
Extend up ward as recess between radius and ulna
Recessus sacciformis
Movement – pronation and suppination along vertical axis
Anterior radioulnar ligament
Posterior radioulnar ligament
Nerve supply
Anterior & posterior interrossius nerve
branch from Median and radial nerve
Radioulnar ligaments
Pronation
Pronator quadratus
Pronator teres
Supination
•Supinator
•Biceps brachii
Movement
Applied anatomy
Wrist joint
 Bi-axial/2 degree of freedom
 Ellipsoid joint
 (Condyloid) type of synovial
joint
 Articular surfaces
 Proximal articular surface
(Elliptical socket)-
 Distal articular surface of
radius & articular disc of distal
radio-ulnar joint
 Distal articular surface:
Scaphoid, Lunate & Triquetral.
Wrist joint
 Ligaments: possess capsular ligament with synovial membrane,
Radial and Ulnar collateral ligament
 Capsular ligament: attach close to the peripheral margin of the
proximal and distal articular surfaces including the articular disc
Wrist joint
 Capsule blends
 Palmar & dorsal radio-carpal
ligaments
 Palmar radio-carpal ligament
 Ant. margin of lower part of
radius to ant. Surface of
scaphoid, lunate, triquetral &
capitate
 Palmar ulno-carpal ligament
• Ant. Margin of articular disc &
styloid process of ulna to lunate
& triquetral
Dorsal radiocarpal
ligament
Wrist joint
 Attachment
 Posterior margin of lower end of radius
 dorsal surface of scaphoid, lunate & triquetral bones
Wrist joint
 Ulnar collateral ligament
 Styloid process of Ulna to triquetral and Pisiform bones
 Radial collateral ligament
 Styloid process of radius to scaphoid and trapezium
Arterial Supply and Nerve Supply Wrist joint
 Nerve supply: anterior and posterior interosseus nerves
 Hilton’s Laws
 Palmar and dorsal carpal arches
 Anterior interosseous artery
 Anterior and posterior carpal brances of radial & ulnar arteries, and
Recurrent branches of Deep palmar arches)
Movements
 Movement of wrist joint: the movements are accompanied by
the movements of intercarpal and midcarpal joint
 Flexion
• FCU, palmaris longus and FCR with assistance from the flexors
of the fingers and thumb
 Extension
• Extensor carpi radialis longus, extensor carpi radialis brevis and
extensor carpi ulnaris with assistance from the long extensor
tendons of finger and thumb
 Adduction
• Flexor carpi ulnaris, extensor carpi ulnaris
 Abduction
• Flexor carpi radialis,extensor carpi radialis longus and
brevis,abductor pollicis longus and extensor pollicis brevis
Applied anatomy
Monteggia's fracture
Proximal third of ulna
Anterior dislocation of head of radius
Galeazzi's fracture
Distal third of radius
Subluxation (partial
dislocation) of head of ulna
(distal ulna)
Radio-ulnar and Wrist joints
Radio-ulnar and Wrist joints
Radio-ulnar and Wrist joints
Radio-ulnar and Wrist joints

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Radio-ulnar and Wrist joints

  • 2. Articulation Radial head and osseo-fibrous ring Annular ligament and radial notch of the ulna 1/5th Osseo-fibrous ring & 4/5th by annular ligament Superior radio-ulnar joint
  • 3. Contd…. Annular ligament is strong fibrous band Attached to the anterior and posterior margin of radial notch Upper border continuous with fibrous capsule
  • 4. •Inferiorly, few fibers from lower margin of annular ligament passes over the synovial membrane and attached to the neck of radius •Thin fibrous ligament called quadrate ligament stretches between the neck of the radius and the upper part of supinator fossa of ulnar and closes joint cavity from below, between radius and ulna •Externally blends with the radial collateral ligament
  • 5. Applied anatomy Nursemaid’s Elbow Subluxation of joint 1-5 year of age Girls- 20%
  • 6. Contd…. • Blood supply: articular branches derived from the anastomoses around the elbow joint • Nerve supply: small branches from the musculocutaneous, median, radial and ulnar nerves • Hilton’s Law
  • 7. Distal radioulnal joint Pivot joint Head of ulna & ulnar notch of radius Synovial membrane extremely loose Extend up ward as recess between radius and ulna Recessus sacciformis Movement – pronation and suppination along vertical axis
  • 8. Anterior radioulnar ligament Posterior radioulnar ligament Nerve supply Anterior & posterior interrossius nerve branch from Median and radial nerve Radioulnar ligaments
  • 11. Wrist joint  Bi-axial/2 degree of freedom  Ellipsoid joint  (Condyloid) type of synovial joint  Articular surfaces  Proximal articular surface (Elliptical socket)-  Distal articular surface of radius & articular disc of distal radio-ulnar joint  Distal articular surface: Scaphoid, Lunate & Triquetral.
  • 12. Wrist joint  Ligaments: possess capsular ligament with synovial membrane, Radial and Ulnar collateral ligament  Capsular ligament: attach close to the peripheral margin of the proximal and distal articular surfaces including the articular disc
  • 13. Wrist joint  Capsule blends  Palmar & dorsal radio-carpal ligaments  Palmar radio-carpal ligament  Ant. margin of lower part of radius to ant. Surface of scaphoid, lunate, triquetral & capitate  Palmar ulno-carpal ligament • Ant. Margin of articular disc & styloid process of ulna to lunate & triquetral
  • 14. Dorsal radiocarpal ligament Wrist joint  Attachment  Posterior margin of lower end of radius  dorsal surface of scaphoid, lunate & triquetral bones
  • 15. Wrist joint  Ulnar collateral ligament  Styloid process of Ulna to triquetral and Pisiform bones  Radial collateral ligament  Styloid process of radius to scaphoid and trapezium
  • 16. Arterial Supply and Nerve Supply Wrist joint  Nerve supply: anterior and posterior interosseus nerves  Hilton’s Laws  Palmar and dorsal carpal arches  Anterior interosseous artery  Anterior and posterior carpal brances of radial & ulnar arteries, and Recurrent branches of Deep palmar arches)
  • 17. Movements  Movement of wrist joint: the movements are accompanied by the movements of intercarpal and midcarpal joint  Flexion • FCU, palmaris longus and FCR with assistance from the flexors of the fingers and thumb  Extension • Extensor carpi radialis longus, extensor carpi radialis brevis and extensor carpi ulnaris with assistance from the long extensor tendons of finger and thumb  Adduction • Flexor carpi ulnaris, extensor carpi ulnaris  Abduction • Flexor carpi radialis,extensor carpi radialis longus and brevis,abductor pollicis longus and extensor pollicis brevis
  • 19.
  • 20. Monteggia's fracture Proximal third of ulna Anterior dislocation of head of radius
  • 21. Galeazzi's fracture Distal third of radius Subluxation (partial dislocation) of head of ulna (distal ulna)

Editor's Notes

  1. Articulation circumference ofhead of radius & anular ligament radial notch of ulna Type : Pivot synovial Capsule : It continuous with that of elbow joint. Annular ligament : -strong fibrous band, surrounding head of radius, keeping it in contact with radial notch of ulna. - it is attached to anterior & posterior margins of radial notch of ulna. -superiorly : it is continuous with capsule of elbow j Synovial membrane : cotinuous above with that of elbow. Nerve supply : median, ulnar, musculocutaneous, and radial nerves. Relations : anteriorly : radial N.(in front of lateral epicondyle). Posteriorly : supinator + common extensor orig