Wrist

• Wrist function pt1:

  • to provide range of motion necessary to adequately perform daily functions while maintaining a physiologic level of inherent stability
  • accomplished, in part, by the osseous articular components creating a condyloid joint that permits simultaneous movement in two perpendicular planes, in this case, dorsopalmar and radioulnar
  • allows for a wide range of motion necessary to facilitate functional use of the hand
  • the joint itself is formed through the articulations between the distal radius and the scaphoid, lunate, and triquetrum
• Wrist function pt2:

  • the proximal articulation forms a concave shape composed of a combination between the distal end of the radius and articular disk
  • the distal articulation is convex and composed of the scaphoid, lunate, and triquetrum bones of the proximal hand. Note that the ulna is not part of the wrist joint itself, as it articulates with the distal via the distal radioulnar joint
• Wrist Anatomy

  A) scaphoid

  B) lunate

  C) triquetral

  D) pisiform

  E) trapezium

  F) trapezoid

  G) capitate

  H) hamate

  
• Lateral View of Wrist:

  A) 1st metacarpal

  B) capitate

  C) scaphoid

  D) lunate

  E) radius

  
• Distal radioulnar joint:

  • also part of the wrist joint
  • synovial joint between distal ends of radius and ulna
  • Uniaxial pivot joint that allows the movements in one degree of freedom; pronation-supination.
  • Crescent shaped convex distal head of ulna and the concave ulnar notch of radius
  • The joint contains a triangular fibrocartilaginous articular disc. The apex of the disc is attached to the lateral surface of the styloid process of ulna, while the base is anchored to the inferior margin of the ulnar notch of radius

  
• Movements at the radiocarpal joint pt1:

  • ellipsoidal (condyloid) synovial joint, allowing for movement along 2 axes
  • all the movements of the wrist are performed by the muscles of the forearm
  • flexion - produced mainly by flexor carpi ulnaris, flexor carpi radialis, with assistance from the flexor digitorum superficialis
  • extension - produced mainly by extensor carpi radialis longus and brevis and extensor carpi ulnaris, with assistance from extensor digitorum
• Movements at the radiocarpal joint pt2:

  • ellipsoidal (condyloid) synovial joint, allowing for movement along 2 axes
  • all the movements of the wrist are performed by the muscles of the forearm
  • ulnar deviation (adduction) - produced by extensor carpi ulnaris and flexor carpi ulnaris
  • radial deviation (abduction) - produced by abductor pollicis longus, flexor carpi radialis, extensor carpi radialis longus and brevis
• Palmar Side:

  • a lot of tendons on the palmar side, especially going under the transverse carpal ligament
  • the tendons are very long
• Dorsal Compartments of the Wrist:

  
• Common Wrist Conditions:

  • Radial Side
  • Fractures:
  • Colle's
  • Smith's
  • Barton's
  • Scaphoid
  • Tenosynovitis:
  • Intersection Syndrome
  • Ulna Side
  • TFCC
  • Tenosynovitis
  • ECU
  • Neural Tissue
  • Ganglion
  • Peripheral Nerve Injuries
  • Carpal Tunnel Syndrome (Median Nerve)