Arthrology of the Wrist and Hand

Question 1

Wrist and Hand joint complex

Answer 1

• Distal Radioulnar joint
• Radiocarpal joint
• Midcarpal joint
• Carpalmetacarpal joints
• Metacarpophalangeal joints
• Interphalangeal joints

Question 2

Distal Radioulnar joint

Answer 2

Pivot joint, uniplanar. Horizontal plane, around a vertical axis.
Pronation, supination (palm posterior). Rotation.
Volar (anterior) radioulnar ligament and dorsal (posterior) radioulnar ligament provide support to the articulation.

Question 3

Radiocarpal joint

Answer 3

Articulation between distal radius and 3 bones of the proximal carpal row (scaphoid, lunate, triquetrum).
Ellipsoidal joint, biplanar.
Flex., ext., radial deviation/wrist abd., ulnar deviation/wrist add.
Articular disc on medial side of wrist (closer to ulna). Stabilizes and creates more surface area.

Question 4

Palmar (Ant.) radiocarpal ligament

Answer 4

• Origin: Radius (Ant.)
• Insertion: Scaphoid + lunate + triquetrum.
• Role: Provide joint stability in the sagittal plane.

Question 5

Dorsal (Post.) radiocarpal ligament

Answer 5

• Origin: Radius (Post.)
• Insertion: scaphoid, lunate, triquetrum.
• Role: Provide joint stability in the sagittal plane.

Question 6

Radial Collateral Ligament

Answer 6

Radius to scaphoid and trapezium.

Limits wrist adduction/ulnar deviation.

Question 7

Ulnar Collateral Ligament

Answer 7

Ulna to triquetrum and pisiform.

Limits wrist abduction/radial deviation.

Question 8

Triangular fibrocartilage complex (TFCC)

Answer 8

Consists of:
- Articular disc
- Radioulnar ligaments (Dorsal and Palmar)
- Ulnocarpal ligaments (ulnotriquetral and ulnolunate)
Increases stability of wrist complex.

Question 9

Carpal Tunnel

Answer 9

Carpal bones make a U-shape, carpal tunnel sits in the pocket.
Median nerve and flexor tendons pass through.
Flexor retinaculum or transverse carpal ligament closes the tunnel on anterior side.

Question 10

Midcarpal joints

Answer 10

Ellipsoidal/condyloid articulation between distal carpal row and proximal carpal row.
Plane joint between separate carpal bones!

Question 11

Intercarpal ligaments (palmar/ant. and dorsal/post.)

Answer 11

Small ligaments that connect all the carpal bones.

Part of midcarpal joint.

Question 12

Carpometacarpal joint of the thumb

Answer 12

Most proximal articulation of the thumb between the trapezium and 1st metacarpal bone.
Saddle articulation (allows the grip function of the hand).
Flex., Ext., Abd., Add. and small rotational components.

Question 13

Carpometacarpal joints of finger 2-5

Answer 13

Plane joints, very little movement.
2nd metacarpal bone - trapezoid.
3rd metacarpal bone - capitate.
4th&5th metacarpal bone - hamate.

Question 14

Metacarpophalangeal joints

Answer 14

Ellipsoidal joint. Flex., Ext., Abd., Add.
Collateral ligaments, one on each side of each articulation:
Medial and lateral. Provide stability.

Question 15

Interphalangeal joints

Answer 15

Hinge joint (single plane). Flex. and Ext. 
One interphalangeal joint on the thumb.
Two interphalangeal joints on fingers 2-5 (proximal & distal).