Dr.MITUL B MANIYA BONE & JOINT DOCTOR
Your hand and wrist are complex parts of your body that let you touch and control objects.
They’re a complicated network of bones, muscles, nerves tendons and ligaments, blood vessels and parts of your lymphatic system.
Your hand and wrist help you interact with the world around you. They’re probably the first body part that comes to mind when you think about your sense of touch.
They help you do everything throughout your day that involves touching, holding or using something with your fingers.
The parts that make up your hand and wrist are layered upon each other to form a three-dimensional shape that gives them the ability to move and function.
Bones.
Muscles.
Nerves.
Tendons.
Ligaments.
Blood vessels (arteries and veins).
Lymphatic vessels
Bones provide the main structural support in your hand and wrist. They give them their shape and are the anchors other pieces are connected to.
Metacarpals: The bones that are in your palm and give it its shape.
Phalanges: The individual bones that make up the segments of your fingers and thumb.
Sesamoids: Small bones embedded in your tendons that help them move smoothly.
Your wrist is a complex joint made of radius ulna bones and carpal bone that are arranged into two rows.
Scaphoid.
Lunate.
Triquetrum.
Pisiform
Trapezium.
Trapezoid.
capitate.
Hamate.
The carpal tunnel is a rounded space between your pisiform, hamate, scaphoid and trapezium. This space is a literal tunnel in your wrist that lets nine tendons, four ligaments and one nerve pass through it to reach the rest of your hand.
Your carpal tunnel is similar to the way that fiber optic cables are buried underground to deliver internet or cable TV service to your home.
Muscles are soft tissue made of stretchy fiber. Intrinsic muscles inside your hand work with extrinsic muscles near the outside of your hand and in your forearm to give your hand its strength and dexterity.
There are 34 muscles in each of your hands. Healthcare providers categorize them into groups, including:
Your muscles and all their possible movements perform two types of grip:
Power: This is where your grip strength comes from. Think about picking up a heavy box or opening a jar.
Precision: Precision is using your hand and fingers to move or touch a smaller object. Precision grip uses your fingers’ ability to meet your thumb (sometimes called an opposable grip) to pinch something between them. Picking up a pen off your desk and turning a key in a lock are precision grip motions.
Your wrist shares muscles with your forearm. Their groups include:
Flexion: Muscles that let you move your wrist down, toward your palm.
Extension: Muscles that pull your wrist up, like you would to make a “stop” gesture at someone in front of you.
Adduction: Muscles that let you bend your wrist in, toward the center of your body.
Abduction: Muscles that let you bend your wrist out, away from the center of your body.
Nerves control your muscles and help you feel and process sensations, including:
Touch.
Temperature.
Pain.
Pressure.
Three main nerves give your hand and wrist sensation:
Radial nerve.
Median nerve.
Ulnar nerve.
All three of these nerves are connected to many branches of smaller nerves that spread out into your hand and wrist.
Tendons link your muscles to your bones. They’re like strong, flexible ropes. Your hand and wrist have two groups of tendons:
Extensor tendons: Tendons that help you extend and straighten your fingers, hand and wrist.
Flexor tendons: Tendons that help you flex and curl your fingers, hand and wrist.
Ligaments are the other type of connective tissue in your hand. If tendons are like ropes, ligaments are more like thick rubber bands. Their main functions include:
Helping your joints move smoothly.
Protecting your joints from bending too far.
Keeping your joints in the proper alignment.
There are lots of ligaments in your hand, including:
Collateral ligaments: These ligaments run on the outside edges of your fingers and thumb. They protect your joints from moving too much from side to side.
The volar plate: Volar plate ligaments connect your first two finger bones (phalanges) together on each finger. They run under your bones on the palmar side of your hand and keep your fingers from bending too far back when you extend them.
Palmar fascia: Your palmar fascia is a thick, triangle-shaped ligament-like structure that runs under the skin of your palm. The narrow point of the triangle is at your wrist, and it gets wider toward the base of your fingers. It helps your hand keep its shape while you move it and prevents your skin from sliding when you’re holding something.
Ligaments in your wrist include:
Ulnocarpal and radiocarpal ligaments: Ligaments that stabilize your whole wrist while it moves.
Collateral ligaments: These are the same ligaments as the ones in your hand. They run on both sides on the outside of your wrist and hold your wrist in place.
Volar carpal ligaments: Ligaments that support and stabilize the bottom (palmar side) of your wrist.
Dorsal radiocarpal ligaments: Ligaments that support and stabilize the back side of your wrist.
radial and ulnar artery
The most common conditions that affect your hand and wrist include:
fracture of bone
Carpal tunnel syndrome.
Arthritis of the hand or arthritis of the wrist (including rheumatoid arthritis, osteoarthritis and psoriatic arthritis).
Tendinitis & synovitis
Trigger finger or trigger thumb.
Dupuytren contracture.
Nerve injury
Ligament and tendon injury
Treatment offered
Fracture fixation - fixation of radius ulna and hand bones
Arthroscpic surgery
WRIST ARTHRODESIS
Complex hand surgery
Ligament and tendon repair
Tendon transfer
Management of tumor and infection.
