The Wrist & Hand Complex - Bones & Bony Landmarks

Which bones make up the wrist & hand complex?

1. The Radius

2. The Ulna

3. The Carpals

4. The Metacarpals (and Phalanges)

What’s the classification of the Radius?

Long bone

How many bony landmarks does the Radius have, and how many relate to the wrist & hand complex?

The Radius has three bony landmarks, and one of them relate to the wrist & hand complex.

Name the one bony landmark of the Radius that relates to the wrist & hand complex.

1. The Radial Styloid Process

Name the bony landmark of the Radius that relates to the wrist & hand complex that can be palpated.

1. The Radial Styloid Process

How many bony landmarks does the Ulna have, and how many relate to the wrist & hand complex?

The Ulna has four bony landmarks, and one of them relates to the wrist & hand complex.

Name the one bony landmark of the Ulna that relates to the wrist & hand complex.

1. The Ulna Styloid Process

Name the bony landmark of the Ulna that relates to the wrist & hand complex that can be palpated.

1. The Ulna Styloid Process

How many Carpal bones are there?

Eight

Name the eight Carpal bones.

1. Scaphoid

2. Lunate

3. Triquetral

4. Pisiform

5. Hamate

6. Capitate

7. Trapezoid

8. Trapezium

Name the four Carpal bones on the Proximal Row.

1. Scaphoid

2. Lunate

3. Triquetral

4. Pisiform

Name the four Carpal bones on the Distal Row.

1. Hamate

2. Capitate

3. Trapezoid

4. Trapezium

Name the Carpal bones that can be palpated.

1. Scaphoid

2. Lunate

3. Pisiform

4. Hamate

5. Capitate

6. Trapezium

How would you palpate Scaphoid?

• Can be located within the ‘anatomical snuff box’ on the posterolateral portion of the wrist (more prominent with the hand moved towards the Ulna)

• Can be found at the distal end of the Radius on the anterior portion of the wrist

What are some fun facts about Scaphoid?

• Most commonly fractured Carpal bone

• Often missed on Xray if performed in the first 24-48 hours

• Has a poor blood supply

• Surgical management common

How would you palpate Lunate?

• Can be best located on the posterior portion of the wrist when in wrist flexion

• It ‘pops up’ like the moon in the sky

What are some fun facts about Lunate?

• Named due to its crescent shape

• Tends to dislocate rather than fracture

How would you palpate Pisiform?

• Can be ‘picked up and wiggled’ on the medial aspect of the wrist

• Easier to wiggle with the wrist in a flexed position

What are some fun facts about Pisiform?

• A sesamoid bone, like the Patella

• It acts as part of a pully system

• Has some important muscle attachments

How would you palpate Hamate?

• Find the ‘hook of Hamate’

• Move distal from the Pisiform

What are some fun facts about Hamate?

• The hook of Hamate forms part of a tunnel for the Ulna nerve to pass

• Prone to fracture, especially in sports that involve gripping equipment

How would you palpate Trapezium?

• Follow the ‘chicken drumstick’ of the thumb

• Should feel small and round

What are some fun facts about Trapezium?

• Articulates directly with the 1st Metacarpal (the thumb)

• It’s shaped like a trapezium (four sided)

• This is a common site of osteoarthritis

How would you palpate Capitate?

• Travel proximally along the 3rd Metacarpal (middle finger)

• Sits next to the Hamate

What are some fun facts about Capitate?

• It’s the largest of the Carpal bones

• It’s shaped like a head

How many bony landmarks does the Metacarpals have?

Two

Name the two bony landmarks of the Metacarpals.

1. Base of Metacarpal (First to Fifth)

2. Head of Metacarpal (First to Fifth)

What does the Base of Metacarpal articulate with?

Trapezium, Trapezoid, Capitate, Hamate

What does the Head of Metacarpal articulate with?

The proximal Phalanges (First to Fifth)

What’s the classification of the Humerus?

Long bone

How many bony landmarks does the Humerus have, and how many relate to the wrist & hand complex?

The Humerus has nine bony landmarks, and two of them relate to the wrist & hand complex.

Name the two bony landmarks of the Humerus that relate to the wrist & hand complex.

1. Lateral Epicondyle

2. Medial Epicondyle

Name the bony landmarks of the Humerus that relate to the wrist & hand complex that can be palpated.

1. Lateral Epicondyle

2. Medial Epicondyle

What is the Lateral Epicondyle of the Humerus the attachment of?

Most of the wrist and finger extensors

What is the Medial Epicondyle of the Humerus the attachment of?

Most of the wrist and finger flexors