Parts of a Hand

Hands are made up of more bones and moving parts than most other areas of the body. When they’re healthy, these parts all work together. They do a large number of tasks. Hands can make very delicate movements. They can also do tasks that need great strength.

• Bones. These are hard tissues that give your hand shape and stability.

• Phalanges. These are the finger bones.

• Metacarpals. These are the middle part of the hand bones.

• Carpals. These are the wrist bones.

• Joints. These are places where bones fit together, allowing movement.

• Ligaments. These are soft tissues that connect bone to bone and stabilize your joints.

• Muscles. These are soft tissues that tighten and relax to move your hand.

• Synovial lining. This makes the fluid inside your joints that helps make movement smooth.

• Volar plates. These are hard tissues that stabilize the joints, keeping fingers from bending backward.

• Tendon sheaths. These are fluid-filled tubes that surround, protect, and guide the tendons.

• Tendons. These are cord-like soft tissues that connect muscle to bone.

• Blood vessels. These carry blood to and from your hand.

• Nerves. These send and receive messages, allowing you to feel and direct movement.

• Palmar fascia. This is a firm layer of soft tissue that stabilizes the palm of your hand.

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Wrist Bones: Anatomy, Function, and Injuries

Your hand consists of your wrist, palm, and fingers. The wrist has many smaller bones and joints, allowing the hand to move in different directions. It also includes the distal ends of the forearm bones. The palm has 5 bones that connect with 14 finger bones.

Let’s take a closer look.

Your wrist is made up of eight small bones called the carpal bones, or the carpus. These irregularly shaped bones join your hand to the two long forearm bones: the radius and ulna.

The carpal bones are small square, oval, and triangular bones. The cluster of carpal bones in the wrist makes it both strong and flexible. Your wrist and hand wouldn’t work the same if your wrist joint were only made up of one or two larger bones.

The eight carpal bones are:

• scaphoid, a long boat-shaped bone under your thumb
• lunate, a crescent-shaped bone beside the scaphoid
• trapezium, a rounded-square shaped bone above the scaphoid and under the thumb
• trapezoid, a wedge-shaped bone beside the trapezium
• capitate, an oval or head-shaped bone in the middle of the wrist
• hamate, a wedge-shaped bone under the pinky finger side of the hand
• triquetrum, a pyramid-shaped bone under the hamate
• pisiform, a small, pea-shaped sesamoid bone (a bone embedded in a tendon or muscle) that sits on top of the triquetrum

Illustration by Jason Hoffman

The wrist has three main joints. This makes the wrist more stable than if it had only one joint. It also gives your wrist and hand a wide range of movement, allowing for many different motions and positions.

The wrist joints let your wrist move your hand up and down, like when you lift your hand to wave. These joints allow you to rotate your hand and bend your wrist forward and backward as well as side to side.

• Radiocarpal joint. The radiocarpal joint is where the radius — the thicker forearm bone — connects with the bottom row of wrist bones: the scaphoid, lunate, and triquetrum bones. This joint is mainly on the thumb side of your wrist.
• Ulnocarpal joint. This is the joint between the ulna — the thinner forearm bone — and the lunate and triquetrum wrist bones. This is the pinky finger side of your wrist.
• Distal radioulnar joint. This joint is in the wrist but doesn’t include the wrist bones. It connects the bottom ends of the radius and ulna.

The metacarpals are the five long hand bones between your wrist and fingers. They make up the palm of your hand and are visible through the skin on the back of your hand. Each metacarpal bone corresponds to a digit (finger) and consists of a base, shaft or body, and head.

Slightly thicker and shorter, the first metacarpal has the most mobility and can move on its own. The second through fifth metacarpals move alongside each other and are similar in size and shape. Of these four bones, the fourth and fifth are the most mobile.

The five metacarpal bones are:

• First (thumb) metacarpal: thickest, shortest metacarpal bone, moves along with with the trapezium
• Second (index) metacarpal: longest metacarpal bone with the largest base that connects to the trapezium, trapezoid, and capitate
• Third (middle) metacarpal: articulates with the capitate
• Fourth (ring) metacarpal: articulates with the capitate and hamate
• Fifth (pinky) metacarpal: smallest metacarpal bone, articulates with the hamate

The finger bones are made up of 14 narrow bones called phalanges. Each of the four fingers consists of a proximal, middle, and distal phalanx. The thumb has a proximal and distal phalanx only.

The three phalanges of the fingers are:

• Proximal phalanx. The proximal phalanx, the largest of the phalanges, forms joints with the metacarpal bone and middle phalanx.
• Middle (intermediate) phalanx. The middle phalanx forms joints with the proximal phalanx and distal phalanx.
• Distal phalanx. The distal phalanx supports the fingernail and sensitive skin of the fingertip and forms a joint with the middle phalanx.

The finger joints provide movement and allow you to perform activities such as pinching and grasping, according to the American Society for Surgery of the Hand (ASSH).

Per the ASSH, the four finger joints are:

• Carpometacarpal (CMC): joint at the distal carpal bone and base of the metacarpal bone
• Metacarpophalangeal (MCP): knuckle joining the metacarpal bone to the proximal phalanx, allows pinching, gripping, and finger movement in multiple directions
• Proximal interphalangeal (PIP): joint between the proximal and middle phalanges, allows finger to bend and extend
• Distal interphalangeal (DIP): joint at the fingertip near the nail bed

The three thumb joints are:

• Trapeziometacarpal (TMC) joint: CMC joint of the thumb, is more specialized and has the most movement and flexibility
• Metacarpophalangeal (MCP): joint connecting the metacarpal bone and the proximal phalanx, used for pinching and gripping
• Interphalangeal (IP): fingertip joint near the nail bed

It’s possible to injure or damage the ligaments, tendons, muscles, and nerves of your wrist, hand, and fingers. Several health conditions can also occur in this area.

Common wrist, hand, and finger injuries and conditions include:

• Sprain. A sprain occurs when you tear or stretch a ligament. This could be due to overstretching, physical impact, or a fall.
• Impaction syndrome. Also called ulnocarpal abutment, this wrist condition happens when the ulna arm bone is slightly longer than the radius. This usually occurs after a wrist fracture has healed in a malunited (atypical) fashion, and makes the ulnocarpal joint between this bone and your wrist bones less stable.
• Arthritis pain. Arthritis can happen in any of the wrist, hand, or finger joints, including the MCP joint. You can get wrist joint pain from arthritis. This can happen from usual wear and tear or an injury to the wrist. You can also get rheumatoid arthritis from an immune system imbalance.
• Fracture. You can fracture any of the bones in your wrist, hand, or fingers from a fall or other injury.
• Repetitive stress injuries. Common injuries to the wrist, hand, and fingers happen from repetitive movements. This includes typing, texting, writing, and playing tennis. Symptoms include swelling, numbness, and pain.
• Carpal tunnel syndrome. This syndrome occurs when the median nerve is compressed. Carpal tunnel syndrome can result from repeated overextension of the wrist, high blood pressure, or diabetes.
• Boxer’s fracture. This impact injury usually affects the fourth and fifth metacarpals. Often, a boxer’s fracture occurs when you use a closed fist to hit a hard object.
• Jersey finger. This common sports injury often occurs in the ring finger, when the tendon near the fingertip pulls away from the bone. Surgery is sometimes necessary.
• Mallet finger. Also called baseball finger, mallet finger is an impact injury that affects the tendon that straightens your finger or thumb. The tendon may tear or detach from the finger bone, causing pain, bruising, and swelling.
• Trigger finger. Also called stenosing tenosynovitis, this condition often affects the thumb and ring finger. It may happen after forceful hand use and is common in people with diabetes and rheumatoid arthritis. Symptoms of trigger finger include pain, stiffness, and a locking or catching sensation when you bend or straighten your finger.

Your hand is made up of 27 bones in the wrist, palm, and fingers. It consists of 8 carpal bones, 5 metacarpal bones, and 14 phalanges.

Along with the hand joints, these bones provide support, flexibility, and dexterity, so you can perform a range of activities and movements.

The hand and facial bones of people in the course of evolution adapted for a fight

The bones of the skull and face of a person changed in such a way as to become more resistant to blows, and the hand in such a way as to deliver this blow as strongly and sharply as possible. The science department of Gazeta.Ru tells how the hands of dead people helped scientists determine the role of fighting in human evolution.

“The idea that aggressive behavior played an important role in human evolution is rather controversial. Many skeptics believe that the ability of a person to make a fist is the result of chance, natural selection, which eventually led to improved fine motor skills. Maybe it is, but if it is really an accident, then it is somehow sad, ”says David Carrier, professor of biology at the University of Utah, USA.

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Professor Carrier’s research team published an article saying that in fact

the ability of a person to clench his hand into a fist indicates that aggressive behavior, in particular fighting, played a much more important role in the lives of ancient people than is commonly believed.

The full text of article is available at in The Journal of Experimental Biology.

The structure of the human palm and hand is indeed different from the structure of the forelimb of great apes: the human palm is shorter and the fingers are longer than in other primates, which allows people to clench their palm into a fist. Scientists believe that such a structure of the hand allowed a person to develop fine motor skills, and ultimately acquire the ability to make and use small tools.

David Carrier and his colleagues dispute this hypothesis, arguing that a person did not need a special structure of the hand for work at all. Scientists conducted a series of experiments in which they used the hands of deceased people to understand how the ability to clench the palm into a fist increases the strength and sharpness of the blow. Researchers have studied this issue before – in 2012 they conducted similar experiments, but then ten men aged 18 to 50 took part in them. This time, the hands of dead people were used in the experiments.

Hands were hung on a special swinging device resembling a pendulum. Fishing lines were attached to the tendons of the forearms and fingers, which made it possible to control the position of the muscles and give the hand the desired direction.

This device struck a prepared target with a hand, and this was done in different ways: in the first case, the fingers of the hand were clenched into a fist, in the second, the fingers of a person were bent at an angle of 90 ° with respect to the palm, and in the third, the blow was applied with the palm of the hand. In total, scientists recorded the force of several hundred hits on the target.

close

100%

The results of the experiments showed that a clenched fist punch is on average 55% stronger than a “relaxed” fist, and a “relaxed” fist hits twice as hard as a palm. In addition, scientists analyzed the likelihood of breaking the bones of the wrist when striking in different ways – it turned out that a tightly clenched fist protects the hand from injury better.

David Carrier and his colleagues claim that the findings confirmed the hypothesis put forward earlier: the structure of the human hand has evolved in such a way as to make the fist an effective weapon, allowing you to hit the opponent hard enough to injure and not break your own bones. palms. At the same time, as the researchers believe, this primarily concerned men, since it was they who resorted to fights, including fighting for women. However, the conclusions of scientists are not limited to this: they assure that

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bones of the human skull were modified to withstand impacts most effectively.

“We are not saying that the only important factor was the need to develop fine motor skills and the ability to fight,” Professor Carrier comments. The evolution of limbs could also be influenced, for example, by genetic drift (random changes in the frequency of a particular gene variant in a population), as well as environmental factors unknown to scientists. Carrier notes that natural selection has led to a lengthening of the big toe and shortening of the other fingers, thanks to which people were able to run faster. It is possible that changes in the genes responsible for the length of the toes led to a change in the length of the fingers.

Although scientists do not state that the “improved” hands were intended primarily for fighting, many researchers criticize the hypothesis of Carrier and his colleagues. In the article, which was published on Thursday night, the professor responds to the criticism of anthropologists.

Skeptics: If one accepts the idea that a person’s face changed in such a way as to most effectively withstand blows, it becomes incomprehensible why the nose remained such a vulnerable part.

David Carrier: In humans (members of the genus Homo), the nose is the only part of the face that does not fit into the theory. It really protrudes forward and is easy enough to break.

However, great apes and Australopithecus have flat noses. In people of the modern type, the bones of the skull have become less massive, but after all, a person has begun to resort to aggression much less often.

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Skeptics: The human hand is not a very good weapon anyway – using a rock or a stick is much more effective.

David Carrier: A study of the damage that can be done with a simple blow demonstrates that the human fist is the simplest and most effective weapon that can cause very serious injury. So, in a fight, the bones of the victim’s face break much more often than the bones of the attacker’s wrist.

Skeptics: If evolutionary mechanisms really worked to make men fight, the body weight of men and women would differ much more.

David Carrier: In the case of man, the difference between body weight, muscle strength, skull and arm sizes of men and women is already great – one of the largest among all living beings.

Skeptics: By nature, people are more cooperative, empathetic and cooperative than conflict.

David Carrier: Agreed.

But it cannot be denied that aggressive behavior has played a huge role in human survival and development.

Our opinion that the evolution of the proportions of the bones of the hand and the ability to clench the palm into a fist can tell us a lot about our history and who we are is just a hypothesis. If the anatomy of our body is indeed adapted for fighting, we must understand that our behavior can always be influenced by emotions and instincts. And reflective behavior in the modern world can be quite dangerous.

symptoms, causes, signs, types and methods of treatment of fractures in the Center of Surgery “SM-Clinic”

general information

Classification

Symptoms

Diagnostics

Operations

Doctor’s opinion

Rehabilitation

Question answer

General information

Fracture of the bones of the hand and wrist is a violation of the integrity of the bone structures of the hand in this area of ​​water by the influence of external forces or internal factors. The condition requires emergency care, comprehensive diagnosis and immediate treatment. Traumatologists and surgeons are engaged in the diagnosis of a “fracture of the hand” and subsequent therapy.

Fracture of the bones of the hand is one of the most common types of traumatic injury to the hand. It occurs as a result of a sharp and strong pressure, which is most often observed during falls with an emphasis on the hands. The cause of a fracture of the hand can also be an attempt to defend against an attack, a collision on the run with large objects, when the patient stops abruptly, putting his hands in front of him.

Injuries of this kind are often found in athletes, dancers, wrestlers, as well as in people who are engaged in extreme hobbies: parkour, jumping, etc.

Classification

Symptoms

Diagnostics

The initial diagnosis is established on the basis of a face-to-face examination. The traumatologist examines the injured limb, finds out the circumstances and time of the injury, evaluates the patient’s complaints. Since the signs of a closed fracture of the hand are in many ways similar to a dislocation of the wrist, an additional study is carried out using radiography, which is performed in several projections.

Additionally, a complex of basic laboratory tests is carried out, if necessary, in difficult cases, the patient is referred for CT or MRI, ultrasound of small joints is performed.

Hand fracture surgery

Conservative therapy is carried out only in relation to simple injuries without displacement of the joints and bone fragments. In all other cases, surgical intervention is indicated.

There are several methods of surgical treatment of fractures of the hand and wrist, and a specific method is chosen taking into account the nature of the injury, the volume of damaged bones, and the patient’s personal health parameters.

Osteosynthesis of bones

The procedure consists in creating favorable conditions for the natural fusion of bone fractures. To do this, the fragments are fastened with special devices and fixed in an anatomically correct position.

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Bone grafting

It involves the placement of healthy patient/donor bone tissue or its artificial analogues in the area of ​​injury, which accelerates the process of fusion and regeneration.

Arthrodesis

The procedure is indicated for extensive multiple multi-comminuted injuries. It consists in immovable fixation of bones with the help of artificial materials in a functionally desired position. Movement in the joint in this case stops.

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Endoprosthetics

It is performed by replacing part of the bone structures with synthetic implants.

In the future, the patient is prescribed a course of rehabilitation and conservative maintenance therapy.

Doctor’s opinion

Rehabilitation

Q&A

The most important thing is to keep the injured limb immobile. You can use a scarf, scarf, clothes to wrap the injured hand to the body. If there is an open wound, it should be carefully covered with a clean cloth.

It all depends on the severity of the fracture. In some cases, only 3-4 weeks are needed, but with complex injuries and extensive surgical intervention, this period can take up to several months.

This is one of the rarest types of hand injuries, when a fracture of the radius occurs simultaneously with a dislocation of the ulna in the wrist joint. The condition is accompanied by very severe pain, sometimes intolerable, severe swelling, complete limitation of arm mobility. Due to dislocation, compression of blood vessels and nerve fibers is observed.