20 December 2010
The wrist is an extremely complicated and intricate set of bones, ligaments, tendons and joints that works together to provide a flexible, extremely mobile and strong appendage. The wrist and hand are an intricate web of bones, and contain all of the necessary mechanics that make it possible to move the fingers dexterously during activities such as typing, being able to grip strongly when picking items up, or the ability to grasp a coffee cup.
The hand and wrist are comprised of 15 bones that are connected from the end of the forearm to the hand; the wrist specifically houses eight bones, called the carpal bones, which form two rows that run horizontally across the wrist. These two rows connect either to the bones of the fingers or to the bones of the forearm, depending on placement.
Ligaments and tendons play a large part in hand and wrist anatomy, as they are the connectors and support system for the intricate system of bones. The tendons of the wrist are the connecting fibers that attach muscle to bone. Additionally, they help in the flexing and movement of the wrist, hand and fingers. Ligaments are the tissues that connect bone to bone.
The reason the wrist and hand are so complex is because they are made of up many joints – everywhere the fingers bend or create a knuckle is a joint, and the wrist itself is made up of many bones and joints. This is also a large reason why arthritis of the hand is so debilitating. If the joints of the hand are subject to the freezing that comes with arthritis, it affects many small joints and causes a great amount of pain and loss of the ability to properly flex and move the hand.
The most common complication of the hand and wrist is carpal tunnel syndrome. Caused by repetitive motion of the fingers and wrist, carpal tunnel affects the hand and wrist and is extremely painful. Those who spend a large portion of their day typing with their wrist immobile will often begin to exhibit carpal tunnel pain. However, carpal tunnel is not exclusive to those who work on computers – anyone who performs repetitive hand and wrist motion can develop carpal tunnel syndrome. Early carpal tunnel syndrome can be treated conservatively with over the counter medications and the use of wrist braces, but advanced carpal tunnel may need to be treated surgically.
Sprains of the wrist can occur after falls or any activity that causes severe twisting of the wrist. Wrist sprains are common in athletes, both professional and recreational. Sprains are usually treated conservatively, with over the counter medications such as ibuprofen or aspirin. Icing the wrist and keeping it immobilized may also be recommended by your physician.
The wrist is most susceptible to a break if a fall is sustained with the hand and wrist taking the impact of the fall.
References:
Raj, (2008) Raj’s Practical Management of Pain.415. (Benzon, Rathmell, Wu, Turk, Argoff Eds.)Philadelphia: Mosby Elsevier
eOrthopod Website at www.eorthopod.com
