Hand and wrist injuries (orthopaedics)

Anatomy

The hand and wrist are made up of several bones held together by ligaments. Many muscles, tendons and nerves run around the hand and wrist.

There are three types of bones in the hand and wrist: the phalanges (14 bones of the fingers), metacarpals (make up the metacarpals) and carpal bones (8 bones of the wrist). Ligaments (ligaments) and connective tissue structures provide a connection between the different bones. In addition, there are intrinsic and extrinsic muscles. The extrinsic muscles are longer and take care of stretching and flexing the wrist and fingers, while the intrinsic muscles are shorter and take care of spreading and closing the fingers.

Nerves control the muscles and provide sensation in the hand. There are three main nerves in the hand: the medianus, ulnaris and radialis. Each nerve takes care of a different part of the hand. When one nerve causes problems, it can cause tingling, numbness or muscle failure in part of the hand.

Carpal tunnel

An important part of the hand is the carpal tunnel. This is a kind of channel formed by the carpal bones. Over it lies a solid band. Nine tendons and the median nerve run through the tunnel. When this nerve becomes compressed and causes symptoms, it is called carpal tunnel syndrome.

Diagnosis

The orthopaedic doctor always first makes a diagnosis through a thorough examination with imaging (radiology) if necessary. Based on the diagnosis made, the specialized doctor prescribes treatment, which may include medication and/or physical therapy.