Normal anatomy of hand & wrist
The human hand is made up of the wrist, palm, and fingers and consists of 27 bones, 27 joints, 34 muscles, over 100 ligaments and tendons, and many blood vessels and nerves.
Physical examination of Hand
Hand pain is characterized by distress in the joints and tissues of the hand or fingers. Hand pain can be depicted as pulsating, aching, increased warmth, prickling, irritation and inflexibility. The hand is composed of nerves, bones, blood vessels, muscles, tendons and skin. Each part has its specific function such as nerves transfer sensation, joints control movements, blood vessels maintain circulation, muscles provides motion, tendons anchor the muscles to the bones and skin receives sensations.
The ability to bend the fingers is governed by supportive tendons that connect muscles to the bones of the fingers. The tendons run along the length of the bone and are kept in place at intervals by tunnels of ligaments called pulleys. When the fingers bend, or are straightened, a slippery coating called tenosynovium helps the tendons smoothly glide through the ligaments with reduced friction.
Dupuytren's Contracture is a hand condition where thickening of the underlying fibrous tissues of the palm cause the fingers to bend inward. Patients with this condition are unable to fully straighten the affected fingers.
De Quervain's Tenosynovitis
The muscles and bones of the hand are connected by thick flexible tissue called tendons. Tendons are covered by a thin soft sheath of tissue known as synovium. Extensor pollicis brevis and abductor pollicis longus are two tendons located on the thumb side of the wrist. Inflammation and swelling of the tendon sheaths puts pressure on the adjacent nerves and leads to pain and numbness in the thumb side of the wrist.
Injuries & Tears
The wrist is more prone to injuries /problems that may include sprains and strains as well as fractures can occur with lifting and carrying heavy objects, wrist injury while operating machinery, bracing against a fall, or sports-related injuries.
Arthritis is an inflammatory condition of joints. There are several types of arthritis and the most common type is osteoarthritis or wear-and-tear arthritis. Arthritis affects various joints in the body and the arthritis in hand affects the joint at the base of the thumb. Arthritis may also affect the joints of other digits and the symptoms include swelling, pain, stiffness, and malformation all of which interfere with use of the hand.
Hands become infected more frequently as it is one of the commonly injured parts of our body. Hand infections, if left untreated or treated improperly can cause disabilities such as stiffness, contracture, weakness, and loss of tissues (skin, nerve and bone) that persist even after the infection resolves. Therefore, prompt treatment of hand infections is important.