. Hand & Wrist Surgery Waco, TX | Wrist Joint Replacement Surgery Waco, TX

Hand & Wrist

Non-surgical Hand Providers

Hand Anatomy

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.

 Hand Anatomy

The hands enable us to perform many of our daily activities such as driving, writing and cooking. It is important to understand the normal anatomy of the hand to learn more about diseases and conditions that can affect our hands.

Bones

The wrist is comprised of 8 carpal bones. These wrist bones are attached to the radius and ulna of the forearm to form the wrist joint. They connect to 5 metacarpal bones that form the palm of the hand. Each metacarpal bone connects to one finger at a joint called the metacarpophalangeal joint or MCP joint. This joint is also commonly referred to as the knuckle joint.

The bones in our fingers and thumb are called phalanges. Each finger has 3 phalanges separated by two interphalangeal joints, except for the thumb, which only has 2 phalanges and one interphalangeal joint.

The first joint close to the knuckle joint is called the proximal interphalangeal joint or PIP joint. The joint closest to the end of the finger is called the distal interphalangeal joint or DIP joint.

The MCP joint and the PIP joint act like hinges when the fingers bend and straighten.

Soft tissues

Our hand bones are held in place and supported by various soft tissues. These include: articular cartilage, ligaments, muscles and tendons.

Articular cartilage is a smooth material that acts as a shock absorber and cushions the ends of bones at each of the 27 joints, allowing smooth movement of the hand.

Muscles and ligaments function to control the movement of the hand.

Ligaments are tough rope-like tissue that connect bones to other bones, holding them in place and providing stability to the joints. Each finger joint has two collateral ligaments on either side, which prevents the abnormal sideways bending of the joints. The volar plate is the strongest ligament in the hand.  It joins the proximal and middle phalanx on the palm side of the joint and prevents backwards bending of the PIP joint (hyperextension).

Muscles

Muscles are fibrous tissues that help produce movement. Muscles work by contracting.

There are two types of muscles in the hand, intrinsic and extrinsic muscles.

Intrinsic muscles are small muscles that originate in the wrist and hand. They are responsible for fine motor movement of the fingers during activities such as writing or playing the piano.

Extrinsic muscles originate in the forearm or elbow and control the movement of the wrist and hand. These muscles are responsible for gross hand movements. They position the wrist and hand while the fingers perform fine motor movements.

Each finger has six muscles controlling its movement: three extrinsic and three intrinsic muscles. The index and little finger each have an extra extrinsic extensor.

Tendons

Tendons are soft tissues that connect muscles to bones. When muscles contract, tendons pull the bones causing the finger to move. The extrinsic muscles attach to finger bones through long tendons that extend from the forearm through the wrist. Tendons located on the palm side help in bending the fingers and are called flexor tendons, while tendons on top of the hand help in straightening the fingers, and are called extensor tendons.

Nerves

Nerves of the hand carry electrical signals from the brain to the muscles in the forearm and hand, enabling movement. They also carry the senses of touch, pain and temperature back from the hands to the brain.

The three main nerves of the hand and wrist are the ulnar nerve, radial nerve and median nerve. All three nerves originate at the shoulder and travel down the arm to the hand.  Each of these nerves has sensory and motor components.

Ulnar Nerve:  The ulnar nerve crosses the wrist through an area called Guyon’s canal and branches to provide sensation to the little finger and half of the ring finger.

Median Nerve: The median nerve crosses the wrist through a tunnel called the carpal tunnel. The median nerve provides sensation to the palm, thumb, index finger, middle finger, and part of the ring finger. 

Radial Nerve: The radial nerve runs down the thumb side of the forearm and provides sensation to the back of the hand from the thumb to the middle finger.

Blood Vessels

Blood vessels travel beside the nerves to supply blood to the hand. The main arteries are the ulnar and radial arteries, which supply blood to the front of the hand, fingers, and thumb. 

The ulnar artery travels next to the ulnar nerve through the Guyon’s canal in the wrist.

The radial artery is the largest artery of the hand, traveling across the front of the wrist, near the thumb. Pulse is measured at the radial artery. 

Other blood vessels travel across the back of the wrist to supply blood to the back of the hand, fingers, and thumb.

Bursae

Bursae are small fluid filled sacs that decrease friction between tendons and bone or skin. Bursae contain special cells called synovial cells that secrete a lubricating fluid.

Conditions

Injuries & Fractures

  • Wrist Fracture

    Wrist Fracture

    The wrist is comprised of two bones in the forearm, the radius and ulna, and eight tiny carpal bones in the palm. The bones meet to form multiple large and small joints...

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  • Fractures of the Hand and Fingers

    The hand is one of the most flexible and useful parts of our body. Because of overuse in various activities, the hands are more prone to injuries, such as sprains and strains...

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  • Wrist Sprain

    Injuries caused due to stretching or tearing of the ligaments in the wrist are called wrist sprains. These injuries are usually caused by a fall during daily activities or sports activities...

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  • Flexor Tendon Injuries

    Flexor Tendon Injuries

    Tendons are the bands of fibrous connective tissue that connect muscles to bone. Tendons aid in movement of the fingers, hand and all other body parts.

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  • Mallet Finger

    Mallet Finger

    Mallet finger is a condition where the end of the finger is bent and does not straighten. It occurs when the extensor tendon on the back of the finger is damaged...

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  • Finger and Thumb Sprain

    Injuries that involve tearing or stretching of the ligaments of your fingers are termed as sprains. Sprains in the fingers are most often caused from a fall when you extend your ...

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  • Thumb Fracture

    Thumb Fracture

    A break or a crack in the bones of the thumb is known as a thumb fracture. Thumb fractures can occur from a direct blow, a fall, and muscle contractions or twisting...

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  • Scaphoid Fracture

    Scaphoid Fracture

    The scaphoid bone is a small, boat-shaped bone in the wrist, which, along with 7 other bones, forms the wrist joint. It is present on the thumb side of the wrist causing it to be at a high risk for fractures.

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  • Finger Dislocation in Children

    Finger dislocation is a condition in which the bone of your finger has moved away from its normal position. Dislocation can be caused from jamming or overextending the finger...

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Arthritis

  • Arthritis of the Thumb

    Arthritis of the Thumb

    Arthritis is an inflammatory condition of joints. There are several types of arthritis; the most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base of the thumb...

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  • Arthritis of the Hand and Wrist

    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...

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Diseases

  • Boutonniere Deformity

    Boutonniere Deformity

    Tendons in your fingers connect the finger bones to finger muscles and help bend and straighten the finger at the joint when the muscles contract. Boutonnière deformity...

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  • Carpal Tunnel Syndrome

    Carpal Tunnel Syndrome

    Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area.

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  • De Quervain’s Tendinosis

    De Quervain’s Tendinosis

    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...

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  • Dupuytren’s Contracture

    Dupuytren’s Contracture

    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...

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  • Trigger Finger

    Trigger Finger

    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...

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  • Congenital Defects of the Hand and Wrist

    The hand and wrist are formed during the 8th week of gestation. This process consists of various steps and failure in any one or more of these steps may cause congenital or birth defects...

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  • Hand Infections

    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...

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  • Wrist Pain

    The wrist is a commonly seen injured joint in the body. Problems include sprains and strains as well as fractures which can occur with lifting and carrying heavy objects, while operating machinery...

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  • Wrist Tumors

    A tumor is a lump or abnormal growth formed due to unregulated cell division. Wrist tumors can occur on or underneath the skin. They are most often benign...

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  • Gamekeeper’s Thumb

    Gamekeeper's thumb, also known as skier's thumb, is a tear of the ulnar collateral ligament, a band of tissue that supports the joint at the base of the thumb. Damage to the ulnar collateral...

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  • Ganglion Cyst

    Ganglion Cyst

    Ganglion cysts are swellings that most commonly develop along the tendons or joints of wrists or hands. They can be found either at the top of the wrist, palm side of the wrist...

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Procedures

  • Wrist Arthroscopy

    Wrist Arthroscopy

    Your wrist is a complex joint made up of eight small bones called carpal bones. These bones are supported by connecting ligaments. Various conditions can affect your wrist...

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  • Wrist Joint Replacement

    Wrist Joint Replacement

    Wrist joint replacement surgery, also referred to as total wrist arthroplasty, involves replacement of a severe arthritic wrist joint with an artificial joint made of metal and plastic components...

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  • Carpal Tunnel Release Surgery

    Carpal Tunnel Release Surgery

    Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area.

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  • Elective Emergency Hand Surgery

    Hand surgery is performed to restore the structure and functionality of the fingers, wrist and hand secondary to a traumatic injury, medical condition, severe infection, or birth defect

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  • Wrist Ligament Reconstruction

    Wrist Ligament Reconstruction

    The human wrist is made up of small bones joined together by a band of tough fibrous tissue known as ligaments. Ligaments also join the bones in our wrist to the radius, ulna, and metacarpal...

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  • Total Wrist Arthrodesis

    Total Wrist Arthrodesis

    Arthrodesis is the surgical immobilization of a joint by the fusion of the adjacent bones. Total wrist arthrodesis, also known...

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  • Sports Injury Management of Hand, Wrist and Elbow

    Sports injuries are the injuries that most commonly occur during sports and exercises. These injuries may result from accidents, poor training practices, and use of improper protective gear...

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  • Artificial Finger Joint Replacement

    Finger joints are essential for many activities, and arthritis in this area can cause significant joint damage and deformity. Artificial finger joint replacement is a surgical procedure...

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  • Finger Joint Fusion

    Finger joint fusion is a surgical procedure to remove the damaged bony ends of a finger joint followed by insertion of a prosthesis to fuse the bones back together. Finger joint fusion...

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  • Arthritis Surgery for Thumb and Digits

    Arthritis is an inflammatory condition of joints. There are several types of arthritis; the most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base...

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Others

  • Hand Rejuvenation

    Cosmetic enhancement is generally focused only on the face, while the hands portray some of the most prominent signs of aging. With age, the hands lose their firmness and plumpness and can appear...

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  • Hand Therapy

    Hand Therapy is a rehabilitation technique recommended to improve the strength and restore functional activity of hands in patients with upper extremity injuries. Hand therapy also helps...

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Hand & Wrist Videos

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