ANATOMY OF THE WRIST
There are 8 carpal bones in wrist named as
Scaphoid, Lunate, Triquetrum, Pisiform, Trapezoid, Trapezium, Capitate and Hamate.
(SHAM LAL TENDAY PAKA TENDAY TERAY CACHY HAIN)
KINAMETICS
Rows
There are two rows of bone in wrist joint are called proximal and distal.
Proximal made up of Scaphoid, Lunate, Triquetrum bone.
Distal row consists Trapezoid, Trapezium, Capitate, Hamate bone.
There are three columns in carpals
Central(flex/ext) column consists Lunate,Capitate,Hamate bone.
Lateral (mobile) is constructed by Scaphoid,Trapezoid,Trapezium bone.
Medial (rotation) made up of only a single bone Triquetrum.
Center of rotation of metacarpals is head of capitate
Radial deviation is a movement in which scaphoid flexes proximal pole goes dorsal
“pulling” lunate into palmar flexion. where as in Ulnar deviation scaphoid extends proximal pole goes volar
pulling lunate into dorsiflexion.
Triquetrohamate helicoid joint
Ulnar deviation : “low” position distal and dorsiflexed pulling lunate into dorsiflexion
Radial deviation : “high”position proximal and palmar flexed
pulling lunate into palmar flexion
Forces Transmission
Principal force transmission is through capitate lunate and
proximal pole of scaphoid 75% radius 25% ulna.
Three axes of motion
Flexion 90 degree
Extension 70 degrees
Flex/ext split between radiocarpal & midcarpal
Radial Deviation 20 degrees
Ulnar Deviation 50 degrees
Pronation 90 degree
Supination 90 degrees
Frykman Classification of Distal Radius
Extra Articular Fractures
Type-I : Trans Radial( with in 1 cm)
Type-II : Radius+Ulna+styloid
Treatment is Conservative with bellow elbow casting.
Intra Articular Fractures
Type-III : RadioCarpal.
Type-IV : RadioCarpal+UlnoStyloid.
Type-V : RadioUlnar.
Type-VI : RadioUlnar+Styloid.
Type-VII : RadioCarpal,RadioUlnar.
Type-VIII : RadioCarpal,RadioUlnar+ Styloid.
Treatment is Conservative with above elbow casting as well as
surgical.
Most Common site of fracture is Scaphoid Due to fall on hands.
No comments:
Post a Comment