Wrist and Hand Injuries Objectives: Understand basic anatomy of wrist Explain various types of injuries Understand common mechanisms that cause injuries to wrist and hand Understand signs and symptoms of various fractures of wrist and hand

Anatomy of Wrist The wrist is the joint between the arm and the hand. It is made up of seven irregularly shaped carpal bones that articulate between the radius and the ulna of the arm and the metacarpals of the hand to allow wrist movement.

Bones of Wrist and Hand Radius and Ulna

Carpals Trapezium Trapezoid Scaphoid Lunate Triquetral Pisiform Capitate Hamate

Metacarpals

Movements of the Wrist Ulnar Deviation Radial Deviation Hyperextension Flexion

Preventing Wrist Injuries Protective Equipment Braces Tape Gloves Padding Stretching and Strengthening

Types of Wrist and Hand Injuries Wrist Sprains Over use Falls Forceful Twisting Signs & Symptoms -Pain -Decreased ROM -Decreased Grip Strength -Some swelling Treatment PRICE Reestablishing ROM and Strength

Dislocation of the Lunate Occurs due to falling on hand that is either in extension or flexion. Signs & Symptoms Deformity Pain Swelling Decreased ROM Treatment Splint and refer to DR.

Gamekeepers Thumb Signs & Symptoms Treatment Injury to medial collateral ligament of the thumb by forcing the thumb into abduction Signs & Symptoms Pain May swell Treatment Splinting Ice Refer to Dr.

Interphalangeal Collateral Ligament Sprains Stressing a collateral ligament on the phalanges beyond normal ROM. Signs & Symptoms Swelling Discolored Treatment Ice Refer to Dr

Dislocation of the interphalangeal Joint or Metacarpal Phalangeal Joint. Signs & Symptoms Swelling Loss of motion Treatment Ice Refer to Dr

Tendonitis Inflammation of the tendon Caused by – overuse, stretching or an impact Prevent by – increasing strength and flexibility, use padding, and by avoiding repetitive injuries.

De Quervain’s Tendonitis Affects the abductor pollicis longus and extensor pollicis brevis. Shot putters who hold the shot while the wrist is in radial deviation are prone to this condition. Signs & Symptoms Difficulty with abduction, swelling and crepitus. Treatment with discontinuation the repetitive movement and PRICE

Mallet Finger Fingertip receiving an impact. Impact causes the extensor tendon to be torn from the bone. Signs & Symptoms Fingertip is in flexion Unable to lift fingertip to straighten Pain, and some swelling Treatment Splint into extension Refer to Dr. Dr. may surgically repair or leave splinted to allow tendon to reattach

Jersey Finger Similar to mallet finger except that the flexor tendon tears from the fingertip. Occurs when the DIP joint is forcibly flexed, such as when the athlete is holding an opponent’s jersey with a fist, and his finger is forced to extend, which tears the tendon. Signs & Symptoms Unable to flex the DIP joint Pain and swelling Treatment Splint and ice Refer to Dr.

Boutonniere Deformity Caused by hard impact over the PIP joint which causes the extensor tendon to fall laterally. Signs & Symptoms Unable to extend the PIP joint Pain and swelling Treatment Splint and Ice Refer to Dr.

Bone Injuries Caused by direct impact Swelling, pain, deformity and disability are common Two complications Non union Avascular Necrosis – Death due to lack of blood supply