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Anatomy of the Hand

 

 

There are very few structures of the human anatomy that are as unique as the hand. Strength and mobility help to form the basis for normal hand function. The hand also needs adequate coordination to perform fine motor activities with precision (Orthopedic Patient Education Material, 2016).

Bones

The wrist has 8 carpal bones which connect distally to the metacarpals and also connect to the two forearm bones which are the radius and the ulna. There are five metacarpals that come together to forming palm of the hand. Phalanges are small bone shafts that line up to form each finger and the thumb (Orthopedic Patient Education Material, 2016).

Joints

The main knuckle joint formed between the connection of the phalanges and metacarpals is called the metacarpophalangeal joint (MCP JOINT). This joint works like a hinge when you straighten and bend your fingers. This area of the hand which is also known as Zone 5 within the dorsum of the hand has been affected by Felix’s laceration injury (Orthopedic Patient Education Material, 2016).

Ligaments

The bones in the hand are held together by a tough band of tissues called collateral ligaments. The are found on either side of the fingers as well as the thumb and play the important role of preventing abnormal sideways bending of each joint  (Orthopedic Patient Education Material, 2016).

Tendons and Muscles

The extensor tendons are an important structure that supports movement of the fingers. They begin as muscles arising from the bones in the forearms and move toward the fingers. Specific to Felix’s injury the muscle affected is the extensor digitorum communis, it is the muscle in the posterior forearm It supports extension of the four fingers. Extensor digitorum minimi orginates on the lateral epicondyle and supports extension of the fifth digit (Orthopedic Patient Education Material, 2016).

 

The small intrinsic muscles (lumbricals and Interossei) are the muscles that start in the wrist. They help to guide movement of the fingers when they are positioned or when they need to maintain steady during various hand activities (Orthopedic Patient Education Material, 2016).

 

 

 

 

 

 

 

 

 

 

 

 

Specific to a zone 5 injury, it is crucial to understand how the sagittal bands are impacted to help prevent lateral migration of the extensor digtorum communis tendon and subsequent metacarpophalangeal extension loss (Griffith, Hindocha, Jordan, Saleh & Khan, 2012). This could have implications in his ability to get back to engaging in previously meaningful occupations like swimming, basketball and typing at a faster rate.

The clinician in the above video discusses how to promote healing with a flexor tendon injury, which is very similar to the rehab process of an extensor tendon injury. 

Splint Care Tips to Help Promote Healing and Reduce Further Trauma
Water and Your Splint

Ensure to keep your splint dry. When moisture collects under the splint it can cause itching and skin irritation. This can increase the risk of infection (Healthwise Alberta, 2015). Powder or cotton stockinette may be worn inside your splint to absorb perspiration (London Health Sciences Centre, Handout). 

 

When taking a shower, tape a sheet of plastic to cover your splint unless advised by the physician that you can take the splint off (Healthwise Alberta, 2015). If you need to clean your splint use cool water and soap (London Health Sciences Centre Handout). 

Splint and Skin Care

If you are allowed to take your splint off make sure it is completely dry when putting it back on and also make sure you don’t put it on too tight (Healthwise Alberta, 2015).  

 

Do not use any type of lotions or oils near your splint. This can irritate the skin and cause further damage. If it becomes red you can use soft material to pat the skin with (Healthwise Alberta, 2015).

 

Keep the splint away from hot areas such as heaters, showers or flame. Avoid leaving the splint in a hot car or sunny window. This can damage the splint and its characteristics (London Health Sciences Centre).

References 

 

Eorthopod (n.d). A patients guide to hand anatomy. Retrieved from http://www.eorthopod.com/hand-anatomy/topic/157.

 

Griffin, M., Hindocha, S., Jordan, D., Saleh, M., & Khan, W. (2012). An overview of the management of flexor tendon injuries. The Open Orthopaedics Journal, 6, 28–35. http://doi.org/10.2174/1874325001206010028

 

HealthWise Alberta. (2015). Splint care tips. Retrieved from https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=abo9627

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