Items tagged “wrist”

The scapholunate interval or gap is the radiographic measurement of the scapholunate joint and widening is indicative of a scapholunate ligament injury. Measurement The scapholunate interval should be measured between the midportion of the scaphoid and lunate on neutral PA, Moneim, PA ulnar de...

Ultrasound is a useful imaging modality for evaluation of the wrist, allowing high-resolution imaging of anatomy while simultaneously allowing dynamic evaluation of the joints, tendons, and ligaments. Approach There are multiple possible approaches to imaging the wrist with ultrasound. The exa...

A bipartite scaphoid is a rare example of a divided carpus. There is controversy whether this condition is congenital (i.e. normal variant) or post-traumatic. Bipartite scaphoids may be unilateral or bilateral. Diagnosis Diagnostic criteria have been proposed 3: no history of traumatic inj...

The space of Poirier is an area of the palmar wrist capsule, between the radial and ulnar capsular ligaments. It lies in the interval between the capitate and lunate and has poor ligamentous support, hence is associated with perilunate dislocation/instability. 

The Matti-Russe procedure involves operative treatment of a non-unified scaphoid fracture by placing a wedge-shaped bone graft from the iliac crest into the scaphoid fracture site, followed by fixation with Kirschner wires (K-wires) 1.  Alternatively the bone graft can be taken from the distal ...

The flexor retinaculum (also known as the transverse carpal ligament) is a rectangular-shaped fibrous band located at the volar aspect of the hand, near the wrist. Gross anatomy The flexor retinaculum encloses and forms the roof of the carpal tunnel. The ulna aspect of the flexor retinaculum f...

The carpal tunnel is a fibro-osseous canal in the anterior (volar) wrist that acts as a passageway for structures between the anterior forearm and the hand. Gross anatomy Boundaries superficial border (roof): flexor retinaculum deep border (floor): carpal groove (formed by palmar aspect of c...

The radiocarpal joint is an articulation between the distal radius and the proximal carpal row of the wrist. It is a major synovial joint of the wrist and is an example of a condyloid joint.  Gross anatomy Location The joint occurs proximally between the concave surface of the distal end of t...

The pisiform (os pisiforme) is a small carpal bone on the medial side of the proximal carpal bones row. It is considered a sesamoid bone within the tendon flexor carpi ulnaris.  Gross anatomy The pisiform sits in an anterior plane to the rest of the carpal bones and articulates with the trique...

Isolated distal radioulnar joint (DRUJ) dislocations are rare and are more commonly part of complex forearm fracture-dislocations.  Clinical presentation Wrist pain, swelling and deformity following FOOSH or direct trauma. The patient will be unable to supinate/pronate the forearm 1,2.  Patho...

Four-corner fusion is a partial fusion technique used in some patients with advanced degenerative change in the wrist. Partial fusion reduces pain from the joint while still preserving some motion (as opposed to a total wrist fusion). Indications Advanced arthritis from scapholunate advanced ...

Die-punch fractures result from an axial loading force on the distal radius. It is an intra-articular fracture of the lunate fossa of the distal radius 1. It is by definition depressed or impacted and is named after the machining technique of shearing a shape, depression or hole in a material wi...

The abductor pollicis brevis muscle is a thin subcutaneous muscle located laterally in the thenar eminence of the hand, and is one of the intrinsic muscles of the hand. Summary origin: mainly from the flexor retinaculum few fibers originate from the tubercles of scaphoid and trapezium and ten...

The opponens pollicis muscle is one of the muscles of the thenar eminence, deep to abductor pollicis brevis, and is one of the intrinsic muscles of the hand. The three muscles that constitute the thenar eminence muscle group are abductor pollicis brevis, flexor pollicis brevis and opponens polli...

Midcarpal (central carpal) dislocation describes an injury where there is dislocation of the capitate from the lunate, and subluxation of the lunate from the radius. This term is somewhat confusing because some authors use "midcarpal dislocation" to refer generally to perilunate and lunate dislo...

Guyon’s canal (also known as ulnar tunnel or canal) is a fibro-osseous tunnel at the anterior aspect of the wrist. It is superficial and slightly proximal to the flexor retinaculum. It is approximately 4 cm in length, spanning from the proximal aspect of the pisiform to the hook of hamate. Gros...

The space of Parona is a potential space in the distal forearm / volar wrist, deep to the flexor tendons. The space lies between the fascia of the pronator quadratus muscle and the flexor digitorum profundus tendon sheath. Its radiologic relevance is that the space can act as a conduit for the ...

The triangular ligaments grouped with the ulnar collateral ligament and meniscal homologue, comprise the ulnar-sided components of the triangular fibrocartilage complex (TFCC). The triangular ligament attaches triangular fibrocartilage to the ulnar tip and fovea. The triangular ligament is comp...

Extensor carpi ulnaris (ECU) tendinopathy is varied and includes tendinosis, (stenosing) tenosynovitis, tendon instability, and (rarely) rupture.  Epidemiology Athletes at increased risk of ECU tendinopathy include those who participate in 1,2: racquet sports, e.g. tennis club sports, e...

Triangular fibrocartilage complex (TFCC) injuries may be traumatic or degenerative in nature. The TFCC is a complex structure consisting of the triangular fibrocartilage (TFC) disc proper, ulnomeniscal homologue and numerous ligaments and tendons. Clinical presentation Traumatic injuries are u...