DIAG 2730 Forearm, Wrist and Hand

DIAG 2730 Forearm, Wrist and Hand - Chapter 16 Forearm,...

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Chapter 16 Forearm, Wrist and Hand
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Overview • The carpus, or wrist, represents a highly complex anatomic structure, comprising: – A core structure of 8 bones – More than 20 radiocarpal, intercarpal, and carpometacarpal joints – 26 named intercarpal ligaments – The six or more parts of the triangular fibrocartilage complex (TFCC)
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Overview • The hand accounts for about 90% of upper limb function – The thumb is involved in 40-50% of hand function – The index finger (2 nd digit) is involved in about 20% of hand function – The middle finger (3 rd digit) aka chiropractic index finger, which accounts for about 20% of all hand function, is the strongest finger, and is important for both precision and power functions
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Bony Anatomy • Distal radio-ulnar joint – A double pivot joint that unites the distal radius and ulna and an articular disc (TFCC) – The rounded head of the ulnar head contacts both the ulnar notch of the radius laterally, and the TFCC distally – The ulnar styloid process is approximately one-half inch shorter than the radial styloid process, resulting in more ulnar deviation than radial deviation ( ROM 30 ° vs. 20 ° )
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Colles’ Fracture aka Dinner Fork Fracture • Fracture of the radius within 20-35 mm of the wrist joint with posterior angulation of the distal fragment.
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Colles’ Fracture aka Dinner Fork Fracture • Fracture of the radius within 20-35 mm of the wrist joint with posterior angulation of the distal fragment.
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Smith’s Fracture - Garden Spade Deformity • Fracture of the radius within 20-35 mm of the wrist joint with anterior angulation of the distal fragment.
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Triangular fibrocartilage complex (TFCC) The TFCC = the fibrocartilage disc in between the medial proximal row and the distal ulna within the medial aspect of the wrist – The primary function of the TFCC is to improve joint congruency and to cushion against compressive forces • The TFCC transmits about 20% of the axial load from the hand to the forearm
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The Wrist – Comprised of the distal radius and ulna, 8 carpal bones, and 5 metacarpals bases – The carpal bones lie in two transverse rows • The proximal row contains (lateral to medial) the scaphoid (navicular), lunate, triquetrum, and pisiform • The distal row holds the trapezium, trapezoid, capitate, and hamate
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The Wrist • Navicular = most commonly fractured • Largest bone of the proximal row of carpals • Ulnar deviation helps to slide it out from under the radial styloid process for palpation
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The Wrist Capitate – largest and most prominent of the MCP bases Largest of all carpal bones Lunate = the 2 nd most often fractured and the most commonly subluxated Lunate, Capitate and base of the 3 rd metacarpal are covered by the extensor carpi radialis brevis tendon which inserts into the base of the 3 rd metacarpal
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Bony Anatomy • Mid Carpal Joints – The midcarpal joint lies between the two rows of carpals – A ‘compound’ articulation because each row has both
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DIAG 2730 Forearm, Wrist and Hand - Chapter 16 Forearm,...

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