The Wrist and Hand

The wrist joint  is a synovial joint, formed by the proximal row of the carpal bones (except the pisiform) and the distal end of the radius, with an articular disk in between. The bones of the hands can be divided up into the carpal bones, the metacarpals, and the phalanges.

One of the most important orthopaedic conditions to be aware of affecting the wrist in the distal radius fracture, often caused by a fall on an outstretched hand. Whilst these can be manipulated back to position if displaced, a sizable proportion may require an operation for appropriate alignment.

Hand surgery is often seen as a complex area of orthopaedics and is often cross-covered with plastic surgeons. Scaphoid fractures are important fractures that should not be missed, as if left untreated they have a high risk for avascular necrosis. 

Carpal tunnel syndrome compression of the median nerve, due to a raised pressure within the carpal tunnel of the wrist. It is a common orthopaedic presentation seen in primary care and if left untreated can result in significant neuropraxia. Other orthopaedic conditions affecting the hands that surgical trainees should be aware of include Dupuytren’s contractures, De Quervain’s Tenosynovitis, and Trigger Finger.