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Wrist/Hand Anatomy Carpals-8  Scaphoid  Trapezium  Trapezoid  Capitate  Hamate  Pisiform  Triquetral  Lunate 

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Presentation on theme: "Wrist/Hand Anatomy Carpals-8  Scaphoid  Trapezium  Trapezoid  Capitate  Hamate  Pisiform  Triquetral  Lunate "— Presentation transcript:

1 Wrist/Hand Anatomy Carpals-8  Scaphoid  Trapezium  Trapezoid  Capitate  Hamate  Pisiform  Triquetral  Lunate  Metacarpals-5 Phalanges - 5  1-5  1=Thumb  5=Pinky

2 Wrist/Hand Anatomy (2) Radiocarpal joints (beween wrist and hand) Metacarpal joints Metacarpalphalangeal Joints Phalangeal joints-PIP and DIP  Normal resting position  Proximal, Middle, Distal phalanx Blood Supply -______________________ Nerve supply  Radial  Medial  Ulnar

3 Colles Fracture ______________________________________ HOPS:  ______________________________________  extreme pain  __________________________________  numbness along the median nerve distribution, extreme pain Treatment: splint, refer fxapcolles.htm fxapcolles.htm

4 Colle's fracture.jpg /hw/colles1.gif

5 Carpal tunnel syndrome (1) Carpal tunnel is located in the anterior of the wrist. ____________________, their synovial sheaths and the median nerve lie in the tunnel __________________________________ ___________________________

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7 Carpal Tunnel (2) Overuse condition caused by repeated wrist flexion, ulnar deviation HOPS  numbness, tingling, median nerve area  muscle atrophy (in advanced cases)  decreased RROM in thumb movement  + Phalen’s test, pn w/ compression of carpal tunnel  + Tinel Sign Tx: rest, wrist splint, anti-inflammatory medication, if severe, surgery

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9 Scaphoid Fracture (1) ________________________________ Lies beneath the “anatomical snuff box” Does not have a good blood supply – often does not heal – “non-union”

10 om/hha/b.wrstfx

11 Scaphoid Fracture (2) HOPS  fall on the outstretched hand  some swelling  pain in anatomic snuff box Tx: refer to physician, immobilization x 6 weeks, protection against impact for 3 months

12 Mallet finger “Baseball”, “basketball” finger ______________________________________ ____________________________ HOPS:  MOI: blow to tip of finger,  pain over the DIP joint  bent DIP joint (about 30 degrees)  inability to extend the DIP joint TX: refer, splint in extension 6 – 8 weeks

13 Mallet Finger /fing-mal.jpg

14 Boutonneire Deformity ______________________________________ ______________________ HOPS:  forced flexion of the interphalangeal joint  swelling, flexion deformity of PIP joint  point tenderness over middle phalanx (dorsal side)  ____________________________ Tx: refer, splint in extension

15 Boutonneire Deformity

16 Jersey Finger ______________________________________ ___________________________ ________________________________ HOPS:  MOI: rapid ext. of the finger while actively flexed  Swelling  point tenderness over DIP joint  ____________________________ Tx: Refer to physician

17 Jersey Finger

18 Gamekeeper’s thumb Sprain of ulnar collateral ligament in thumb MOI: ________________________________ ___________________ HOPS:  Swelling over palmar aspect  Instabilty in the joint  Laxity in thumb flexion Tx: refer to physician, tape, rest, surgery

19 es/body_parts/skiers_thumb.jpg

20 Boxer’s Fracture Fracture to the 4 th and/or 5th metacarpal(s). MOI - caused by punching something harder than the hand, such as a wall or another person's head. The end of the metacarpal bone takes the brunt of the impact, which usually breaks through the narrowest area near the end (the "neck"), and bends down toward the palm.

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23 Boxer’s Fracture – (2) HOPS- _________________________ ____________________________  Swelling/Discoloration in area  Deformity  Pain Pt tender at location of fracture  ___________________________________ Treatment- Splint, refer for x-rays, possible surgery

24 ROM/Strength Testing Wrist Flexion-Palmaris Longus Wrist Extension-Extensor Digitorum Wrist Radial Deviation-Flexor/Extensor Carpi Radialis Wrist Ulna Deviation-Flexor/Extensor Carpi Ulnaris Finger Flexion/Extension-Flexor Digitorum/ Extensor Digitorum Finger Abduction/Adduction Opposition

25 Test Valgus Stress Test - Ulna Collateral Ligament - +sign laxity Varus Stress Test - Radial Collateral Ligament - +sign laxity Phalen’s- Median Nerve - +sign numbness/tingling Tinel’s – Ulna and Median Nerve - +sign numbness/tingling Fracture Testing- Compression, Distraction, Flick


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