1. 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

2. 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.

3. Bones of Wrist and Hand
Radius and Ulna

4. Carpals Trapezium Trapezoid Scaphoid Lunate Triquetral Pisiform
Capitate
Hamate

5. Metacarpals

6. Movements of the Wrist Ulnar Deviation Radial Deviation Hyperextension
Flexion

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

8. 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

9. 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.

10. 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.

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

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

13. 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.

14. 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

15. 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

16. 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.

17. 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.

18. 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