04 Wrist

Bones

Scaphoid

  • palmar and dorsal branches supply scaphoid
  • blood to distal/lateral first then proximal/medial
  • avascular necrosis to proximal portion

  • waist of scaphoid fracture
  • result in nonunion

Lunate

  • B
  • sits on top and attaches to radius
  • rest of bones fall backward. Lunate attached and falls forward

  • if displaced anteriorly in dislocation can compress carpal tunnel

Carpel Tunnel

  • carpel: wrist bone
  • tunnel: median nerve inside, between flexor retinaculum and bones

  • pic: everything in yellow
  • small branch of median come off before carpel tunnel and provides sensory innervation over thenar
  • carpel tunnel: sensory loss of lateral fingers but not thenar

  • association with carpel tunnel

Guyon's Canal

  • how ulnar gets into hand, can be compressed
  • above transverse ligament and not below

  • use screwdriver often

Pediatric

  • children have softer bones
  • bone doesn't completely snap in two

Greenstick

  • part of bone still attached medially

Torus