Forearm, Wrist, Hand, and fingers - quick review

Forearm

• Anatomy

  • Bones

    • Radius

    • Ulna

  • Articulations

    • Superior radioulnar - pivot joint

    • Middle radioulnar

    • Distal radioulnar

  • Muscles

    • Flexor carpi radialis - wrist flexion, radial deviation, assists elbow flexion, pronation

    • Palmaris longus - wrist flexion

    • Flexor carpi ulnaris - wrist flexion, ulnar deviation

    • Flexor digitorum superficialis - wrist flexion, finger flexion

    • Flexor digitorum profundus - wrist flexion, finger flexion

    • Flexor pollicis longus - flexes thumb, assists in wrist flexion

    • Pronator quadratus - hand pronation

    • Extensor carpi radialis longus - wrist extension, radial deviation

    • Extensor carpi radialis brevis - wrist extension, redial deviation

    • Extensor digitorum communis - wrist and finger extension

    • Extensor carpi ulnaris - wrist extension, ulnar deviation

    • Abductor pollicis longus - thumb abduction, radial deviation

    • Extensor pollicis brevis - thumb extension, ulnar deviation

    • Extensor pollicis longus - thumb extension, radial deviation

    • Extensor indicis - extends index finger

  • Nerve and blood supply

    • Medial nerve - flexors

    • Radial nerve - extensors

    • Brachial artery --> radial and ulnar arteries

• Injuries

  • Contusions

  • Forearm splints

  • Forearm fractures

  • Colles' fracture

  • Smith's fracture

  • Madelung deformity

Wrist, hand, fingers

• Anatomy

  • Bones

    • Scaphoid

    • Lunate

    • Triquetrum

    • Pisiform

    • Trapezium

    • Trapezoid

    • Capitate

    • Hamate

  • Articulations

    • Radiocarpal joints

      • UCL

      • RCL

      • Transverse carpal ligament

    • Carpal joints

    • Metacarpal joints

    • Phalangeal joints

  • Muscles

    • Lumbricales - MCP flexion, interphalangeal flexion

    • Doral interossei - abduction of fingers

    • Palmar interossei - adduction of fingers

    • Abductor pollicis brevis -  thumb abduction

    • Opponens pollicis - pulls thumb in front of palm to touch little fingers

    • Flexor pollicis brevis - flexion, thumb adduction

    • Adductor pollicis - thumb adduction

    • Palmaris brevis - Pulls on skin over hypothenar eminence, deepening the cup of the palm and improving grip

    • Abductor digiti minimi - abduction of 5th finger

    • Flexor digiti minimi brevis - flexion of 5th finger

    • Opponens digits minimi - brings 5th finger out to touch thumb

  • Nerve and blood supply

    • Ulnar nerve - 4th and 5th finger

    • Radial nerve - thumb and thenar area

    • Median nerve - 2nd and 3rd finger

    • Radial and ulnar artery

  • Normal ROM

    • Wrist flexion - 80-90 degrees

    • Wrist extension - 75-85 degrees

    • Radial deviation - 20 degrees

    • Ulnar deviation - 35 degrees

    • Supination - 90 degrees

    • Pronation - 90 degrees

• Wrist Injuries

  • Wrist sprain

  • Triangular fibrocartilage complex injury (TFCC)

  • Tenosynovitis

  • Tendinitis

  • Nerve compression, entrapment, palsy

  • Carpal tunnel

  • DeQuervain's disease (Hoffman's disease)

  • Dislocation of lunate

  • Scaphoid fracture

  • Hamate fracture

  • Wrist ganglion

• Hand and Finger Injuries

  • Contusions/pressure injuries

  • Bowler's thumb

  • Trigger finger or thumb

  • Mallet finger

  • Boutonniere deformity

  • Swan neck deformity (distal)

  • Pseudoboutonniere deformity (proximal)

  • Jersey's finger

  • Dupuytren's contracture

  • Sprain

  • Dislocation

  • Fractures

  • Gamekeeper's thumb

  • Interphalangeal joint sprain

  • PIP dorsal dislocation

  • PIP palmar dislocation

  • MCP dislocation

  • Metacarpal fracture

  • Bennett's fracture

  • Distal phalangeal fracture

  • Middle phalangeal fracture

  • Proximal phalangeal fracture

  • PIP fracture/dislocation

  • Handlebar palsy

  • Paronychia/felon