The Wrist, Hand and Finger Joints

The Wrist, Hand and Finger Joints

• The hand and the wrist are made up of 27 bones. The wrist is formed where the two bones of the forearm (the radius and ulna) meet the carpus (wrist). The wrist is made up of multiple joints to allow movement where the bones and the hand meet. The carpus is formed of eight small bones, the carpal bones, which are bound in two groups of four bones.
• The other bones of the hands are the metacarpals, the five bones that comprise the middle part of the hand and phalanges, the 14 narrow bones that make up the fingers of each hand (each finger has 3: the distal, middle, and proximal) and the thumb has two. 

• The surfaces of the bones where they meet to form joints are covered with a layer of cartilage. The joints are enclosed by a fibrous capsule that is lined with a thin membrane called the synovium, which secretes synovial fluid to lubricate the joints.
• The hands and wrist have several other important structures:
• Ligaments – tough bands of connecting tissue that connect the bones to support them and keep them in place
• Tendons – bands of connecting tissue that attach the muscles to the bone enabling the muscles to move the bones
• Nerves – the median, radial and ulnar nerves run the length of the arm through the wrist and into the hand to give sensations of touch, heat and pain

 Common Injuries of the Hand and Wrist

• Osteoarthritis – age related to wear and tear which can also cause deformity
• Rheumatoid arthritis – an autoimmune condition
• Carpal tunnel syndrome – compression of a nerve as it goes through the wrist
• Tendonitis – irritation of the tendons
• Fractures and dislocations – both fingers and wrists
• Ruptured ligaments – both fingers and wrists
• Dupuytren’s contracture – the fixed contracture of the fingers in the flexed position with nodes in the palm

Hand Treatments

• Pain Medication – OTC and prescription analgesics and injections of steroids
• Rest, Ice, Heat – relieve pain and inflammation
• Physical Therapy – including ultrasound and stretching exercises to improve mobility and relieve symptoms
• Enzyme Injections – to break up tough tissue in dupuytren’s contracture
• Surgery – required to repair or reconstruct ligaments and in some cases correct carpal tunnel syndrome and dupuytren’s contracture