Wrist joint


Cutting right hand:
1 - interosseous membrane;
2 - radial bone;
3 - wrist joint;
4 - navicular bone;
5 and 12 - lateral radiation and elbow ligament wrist;
6 and 7 small and large trapezoidal bones;
8 - metacarpal bones;
9 - capitate bone;
10 - hooked bone;
11 - triangular bone;
13 - joint drive;
14 - elbow bone.

Wrist joint - connection of the forearm with a brush. The wrist joint is formed of the radial bone and the bones of the wrist - scaphoid, lunate and triangular (Fig). It is possible movements: the flexion and extension, conversion and disposal of the brush. Capsule wrist joint with its top edge attached to beam the triangular bone and cartilage, and the lower - to the first row of the bones of the wrist. On the Palmar surface of the wrist joint are two synovial vagina, through which the flexor tendons, located in four layers. Tendon extensor at the level of the wrist joint are in synovial sheaths and are located on the back surface of the wrist joint in two layers. The blood supply of palm side of the wrist joint is derived from the radial and ulnar artery, each of which is accompanied by two veins. The back surface of the wrist joint receives blood from the back of the branches of the radial artery. Innerviruetsya joint branches of the elbow and median nerves. Lymph is a deep lymphatic vessels in the axillary lymph nodes.
The damage. The wrist joint injuries occur relatively rarely. Tension occurs when a sudden excessive bending, straightening, lead and adjustment brush and is accompanied by a ligament damage. However in a limited area of the wrist joint is determined by swelling and pain on movement. Diagnosis stretching put only after elimination of fracture, radiation and scaphoid bone. Treatment: the cold, the compression bandage or back of plaster of Paris splint is placed on the hand and forearm in 3-6 days.
The dislocations in the wrist joint occur very seldom, often occur dislocations Crescent or the scaphoid. First aid for sprains is reduced to the imposition imobilizarea armband type kerchiefs. Treatment - reduction of dislocation - General anaesthesia is performed by a physician; after reduction impose a plaster of Paris splint is placed for 3 weeks. Then designate the thermal procedures, remedial gymnastics.
Of intra-articular fractures of the bones of the wrist joint is more often the scaphoid fractures and lunate bone. Scaphoid fracture occurs in the fall on an outstretched hand, can be combined with a fracture of a radial bone in a typical location (see the Forearm). Symptoms include swelling, pain, and difficulty when moving in the wrist joint. Specifies diagnosed radiographically. Treatment: the imposition of a plaster splint on 8-10 weeks. In the following for the development of joint functions - medical gymnastics, heat treatment.
Injured wrist (more firearms in peacetime are rare. First aid is to impose aseptic bandage, immobilization limbs, the introduction of anti-tetanus serum on Besedka. In the hospital - primary treatment of wounds, bleeding, remove bone fragments and other; then impose a plaster cast from the metacarpophalangeal joints up to the middle third shoulder in a functionally advantageous position of the elbow and wrist joint. Primary processing of open injuries of the wrist joint prevents the development of purulent complications in the wrist joint, and (in later periods) osteomyelitis.
The disease. Arthritis wrist occurs mainly as a complication of purulent tenebrio as a result of penetrating wounds or tuberculosis infection (see Arthritis, Tuberculosis of bones and joints).

Wrist joint (subtalar radiocarpea) connects forearm with a brush. In this articulation participate and proximal radial bone several bones of the wrist - scaphoid (os scaphoideum), semilunar (os lunatum) and triangular (os triquetrum). Between the first and the second near the bones of the wrist has megaparty joint, which together with the wrist joint produces functionally connected between the wrist. Joint and socket forms carpal articular surface of the radial bone (facies articularis carpea radii), which connects with navicular and lunate bone and triangular cartilage tissue (discus articularis), performing the gap between shorter than radial bone, ulna, and which is the articular surfaces for triangular bone. Distal radial and ulnar bones are connected articulation (art. radioulnaris distalis).
Capsule wrist joint is very thin. The upper edge of it is attached to the edge of the articular surface radiation triangular bone and cartilage, and the lower - to the edge of the articular surfaces of the first row of the bones of the wrist. The joint capsule is fortified with the sides of the beam lateral ligament of the wrist (lig. collaterale carpi radiale) and ulnar collateral ligament wrist (lig. collaterale carpi ulnare). In addition, from the radial bone to the bones of the wrist from the Palmar surface of the stretched hand wrist ligament (lig. radiocarpeum palmare). The same bundle (lig. radiocarpeum dorsale) available on the rear side (Fig. 1 and 2). Capsule wrist joint is powered vessels, forming rete carpi palmare (see the Brush).
On the Palmar surface of the wrist joint are two synovial vagina, which under a u flexorum - tight bond, which is a continuation of Palmar aponeurosis, are flexor tendons. The core muscles, bending brush, are the radial and elbow flexors wrist (brush) and long Palmar muscle (mm. flexor carpi radialis, palmaris longus et flexor carpi ulnaris). Straightening brush produce long and short beam wrist extensor (brush) and elbow extensor (mm. extensores carpi radiales longus et brevis et m. extensor carpi ulnaris). Extensor tendon at the level of the wrist are in sheaths and pass under a u extensorum. On the Palmar surface HP-SS tendons and muscles are located in four layers, on the back - in two layers. In addition to these muscles flexors and extensors of the brush, the other muscles have an indirect effect on the function of the joint.
The blood supply from the Palmar side of the joint receives from radial and ulnar
arteries. Radial artery accompanied by two veins and is superficial. Ulnar artery runs in the elbow furrow forearm accompanied by two veins. Medial to the artery is the ulnar nerve. The median nerve passes through the Palmar surface of the wrist joint with flexor tendon. Unlike tendons, with the cut-lamellar structure, the median nerve has a cable structure (consists of separate longitudinal fibers). It is important to remember when the binding of the ends of the damaged tendon and nerve. Back surface HP-SS receives blood from the back of the branches of the wrist radial artery (ramus carpeus dorsalis) and the back of the arterial network of HP-SS (rete carpi dorsale).
HP-SS is ellipsoid-axle joint, which allows motion in the sagittal and frontal plane of the brush.