Hand & Wrist Surgery

The Hand and Wrist: Bones, Ligaments, and Their Functions

Structure of the Hand and Wrist

• The hand and wrist are intricate structures composed of bones, ligaments, and tendons that allow for a wide range of motion and dexterity. The wrist connects the hand to the forearm, essential for movements like gripping, lifting, and rotating.

Bones of the Hand and Wrist

• Carpal Bones: Eight small bones forming the wrist, arranged in two rows.
• Proximal Row: Scaphoid, Lunate, Triquetrum, Pisiform.
• Distal Row: Trapezium, Trapezoid, Capitate, Hamate.
• Metacarpal Bones: Five bones forming the middle part of the hand, each connected to a finger.
• Phalanges: Finger bones. Each finger has three phalanges (proximal, middle, distal), except for the thumb, which has two (proximal, distal).

Major Ligaments of the Wrist

• Radial Collateral Ligament: Stabilizes the wrist and prevents excessive side-to-side movement.
• Ulnar Collateral Ligament: Also stabilizes the wrist on the pinky side.
• Dorsal Radiocarpal Ligament: Controls wrist extension.
• Palmar Radiocarpal Ligament: Controls wrist flexion.

Wrist Movements

• Flexion: Bending the wrist forward.
• Extension: Bending the wrist backward.
• Radial Deviation: Moving the wrist towards the thumb side.
• Ulnar Deviation: Moving the wrist towards the pinky side.
• Pronation: Rotating the forearm so the palm faces downward.
• Supination: Rotating the forearm so the palm faces upward.

Finger Movements

• Flexion and Extension: Bending and straightening the fingers.
• Abduction and Adduction: Spreading the fingers apart and bringing them together.
• The Scaphoid Bone: Located near the base of the thumb, the scaphoid bone is commonly fractured and plays a crucial role in wrist stability and motion.
• The Lunate Bone: Situated in the center of the proximal row of carpal bones, the lunate bone is involved in wrist flexion and extension.
• The Triquetrum Bone: Found next to the lunate, the triquetrum helps stabilize the ulnar side of the wrist.
• The Pisiform Bone: A small, pea-shaped bone sitting on top of the triquetrum, serving as an attachment point for ligaments and tendons.
• The Trapezium Bone: Located near the base of the thumb, the trapezium allows for a wide range of thumb movements.
• The Trapezoid Bone: A small bone next to the trapezium, helping stabilize the base of the index finger.
• The Capitate Bone: The largest carpal bone, situated in the center of the wrist, is key for wrist motion.
• The Hamate Bone: Recognizable by its hook-like projection, the hamate bone is involved in the movement and stability of the ring and pinky fingers.
• The Role of Tendons: Tendons connect muscles to bones, enabling motion. The tendons in the wrist and hand control movements such as gripping and finger flexion/extension.

Common Wrist & Hand Injuries

• Sprains: Stretching or tearing of ligaments.
• Fractures: Breaks in bones, often involving the scaphoid or radius.
• Tendonitis: Inflammation of tendons due to overuse.

Hand and Wrist Surgeries at Welcare Hospital, Vadodara

Hand Surgeries:

• Carpal Tunnel Release: Relieves pressure on the median nerve to treat carpal tunnel syndrome.
• Trigger Finger Release: Releases the affected tendon sheath to alleviate a bent finger condition.
• Dupuytren’s Contracture Surgery: Corrects a hand deformity causing fingers to bend towards the palm.
• Fracture Fixation: Repairs broken hand bones using pins, screws, or plates.
• Tendon Repair: Fixes torn or damaged tendons to restore hand function.
• Nerve Repair: Reconnects severed or damaged nerves to restore sensation and motor function.
• Ganglion Cyst Removal: Removes fluid-filled cysts on the wrist or hand.
• Joint Fusion: Fuses bones in a joint to alleviate pain and improve stability.
• Ligament Repair: Repairs torn ligaments to restore stability and function.
• Finger Replantation: Reattaches severed fingers to restore function.

Wrist Surgeries:

• Wrist Arthroscopy: Minimally invasive procedure to diagnose and treat joint problems.
• Scaphoid Fracture Fixation: Repairs scaphoid fractures using screws or pins.
• TFCC Repair: Fixes tears in the cartilage and ligaments on the pinky side of the wrist.
• Wrist Fusion (Arthrodesis): Fuses wrist bones to alleviate severe arthritis pain.
• Wrist Ligament Reconstruction: Reconstructs torn ligaments using a graft.
• Wrist Tendonitis Surgery: Treats severe tendonitis by removing inflamed tissue.
• De Quervain’s Release: Relieves pain from De Quervain’s tenosynovitis.
• Ganglion Cyst Removal: Removes wrist cysts.
• Distal Radius Fracture Fixation: Repairs fractures of the distal radius bone.
• Proximal Row Carpectomy: Removes proximal row of carpal bones to alleviate pain and improve wrist motion.

These surgeries aim to restore function, alleviate pain, and improve the quality of life for patients with various hand and wrist conditions.