Hand &WristCare and Prevention of

athletic injuriesChapter 12

Ms. K

WRIST & HAND ANATOMY

Fingers named by #1-5 starting at the thumb

Joints named after the bones that come together

Muscles: Wrist extensors are posterior

on the forearm Wrist flexors are anterior on

the forearm

WRIST & HAND ANATOMY Ligaments:

Every finger has 2 collateral ligaments

Radial/lateral collateral ligament

Ulnar/Medial collateral ligament

Triangular fibrocartilage complex

Anatomical Snuff Box

The boundaries The posterior border of the

snuffbox is the tendon of the extensor pollicis longus.

The anterior border are the extensor pollicis brevis and the abductor pollicis longus.[1]

The proximal border is formed by the styloid process of the radius

The floor of the snuffbox varies depending on the position of the wrist, but both the trapezium and primarily the scaphoid can be palpated.

TFCC

The Triangular fibrocartilage complex (TFCC) is formed by: Triangular

fibrocartilage discus (TFC)

Radioulnar ligaments (RUL’s)

Ulnocarpal ligaments (UCL’s).

DeQuervain’s Tendonitis Tendonitis of the abductor

pollicus longus and extensor pollicus brevis (muscles that move that thumb) AKA as “Trigger Finger”

MOI: Repetitive motion (radial deviation) of the wrist

Signs/Symptoms: Pn with abduction Swelling Crepitus

Treatment: RICE NSAIDS Strengthening of hand

muscles

Mallet Finger MOI: Hit at the tip of the

finger Extensor tendon tears

from bone Signs/Symptoms:

Finger is in flexion Cannot straighten

finger because tendon is unattached

Management: Pain Swelling Splint in extension Surgery to reattach

Jersey Finger Flexor tendon tears away

from fingertip MOI: DIP jt is in flexion

and is suddenly forced to extend (i.e. grabbing a jersey)

Signs/Symptoms: Pain Swelling DIP jt is unable to flex

Management: Splint Ice Surgery

Wrist Sprain MOI:

FOOSH Excessive radial/ulnar

deviation Signs/Symptoms

Pain Decreased ROM Decreased grip strength Swelling Laxity

Management: RICE Splint Rehab to strengthen

hand muscles

Ganglion Cyst Occurs when the sheath

covering the muscles becomes filled with fluid

A.K.A. “Bible’s cyst” Signs/Symptoms:

Bubble develops on wrist

Painful at times Management:

Ice with compression If persistent, needs to

be drained by physician

Gamekeeper’s Thumb MOI: Injury to medial collateral ligament of

thumb due to forced abduction (i.e. catching a basketball)

Signs/Symptoms: Pain Swelling Loss of ROM

Management: Ice Splint Xray to r/o fx

Interphalangeal Collateral Ligament Sprain

MOI: Joint is stressed beyond normal limits I.e. finger hits a ball,

land with fingers extended or curled

Signs/Symptoms: Pain Swollen Ecchymosis Loss of ROM

Management: XRAY to r/o fx Ice in ice cup Splint

Dislocation of Interphalangeal or Metacarpophalangeal Joints

MOI: Bones of joint are forced in opposite directions

Signs/Symptoms: Obvious deformity Pain, Swelling Ecchymosis Loss of ROM

Management: Refer to physician for reduction