THE COMPLEX ANATOMY OF THE HAND AND WRIST: AN INTRODUCTION
In order to understand how to treat many diseases and traumas of the hand, it is first necessary to have a good understanding of how the bones, soft tissues, and joints of the arm, hand, fingers, and thumb work together to allow you to grab, hold, and move as effectively as you do. If you are seeking treatment for a hand-related medical concern, we encourage you to take the time to become educated about the anatomy of the hand; the more you know about the complex structures of the hand, the better able you will be to work with your medical team to determine the correct treatment approach.
Dr. Asaf Yalif, lead surgeon at Y Plastic and Reconstructive Surgery, is Triple Board Certified in Plastic Surgery, Hand Surgery, and Orthopedic Surgery (only surgeon in the Atlanta area to offer this unique combination of specializations), giving him a level of training and expertise critical for understanding the complex anatomy of the hand and for treating an extremely wide range of hand-related disorders. At his offices in Atlanta, Roswell, Woodstock, GA, you will discover a boutique-style, patient-friendly surgical practice your individual problem area will be properly diagnosed and treated to enable your fingers and hands to move and function as optimally as possible, as quickly as possible!
- Bones: The hard, lightweight pieces of our skeletal structure that give our body form and shape, protect our internal organs, and provide a frame for the soft tissues that allow our bodies to flex and move.
- Joints: A joint is formed where two bones come together, enabling movement. Fibrous joints are held together by tough collagen fibers, while cartilaginous joints are bound together by bands of cartilage, a rubbery, elastic tissue. Synovial joints have a fluid-filled space between cartilage pads at the ends of the bone. Joints can also be classified by how they move: gliding joints (between the carpals in the wrist) enable flat bones to glide past one another in any direction; hinge joints limit movement in only one direction (like the elbow or fingers); and saddle joints (such as between the carpals and the metacarpals) allow the bones to pivot along two axes, enabling 360 degree range of motion.
- Muscles: Skeletal muscles are attached to two bones across a joint and control the movement of that joint by contracting and expanding, bringing the two bones closer together or farther apart. Every movement we make involves multiple skeletal muscles flexing and contracting in different directions.
- Tendons: Tough, fibrous, connective tissue that attaches muscles to bone. When a joint is moved by the contraction of the muscle, the tendon transmits that movement from the muscle to the bone.
- Ligaments: Tough, elastic bands of connective tissue that surround a joint to give it support and limit its range of movement to prevent dislocations.
ELBOW AND FOREARM
The human arm is composed of three long bones that meet at the elbow joint. The humerus extends from the shoulder to the elbow, while the forearm is composed of two bones: a shorter, thinner bone on the inside (near the thumb) of the forearm known as the radius and a longer, wider bone on the outside (near the pinky) known as the ulna. The radius becomes wider as it nears the wrist, and forms the bulk of the wrist joint. The majority of muscles and tendons that control movement of the hand, including the wrist, fingers, and thumb, start at the bones of the arm. For instance, the forearm tendons (extensors) attach either to the lateral epicondyle, the bony bump on the outside of the elbow (the base of the humerus) or to the medial epicondyle on the inside of the elbow.
The hand and wrist contains an amazing 27 different bones with many, many flexible joints at the points where these bones meet and glide across each other to enable flexibility and range of motion. The wrist is a complex collection of eight bones known as the carpals that join the bones of the arm to the bones of the hand. These bones are roughly shaped liked small cubes, jointed together in two rows of four bones each. Where these bones are jointed with the radius, they form a slightly rounded shape, while they are concave on the palm side of the hand, forming a canal (the carpal tunnel) that allows tendons, ligaments, and nerves to pass from the forearm into the palm. At the top of the carpal bones are the palmer carpometacarpal ligaments which join the wrist to the bones of the hand.
The hand itself is composed of five long bones—the metacarpals—extending from the carpals out toward the fingers; these are the supporting bones in the palm of the hand. Extending from the metacarpals are the fourteen phalanges, or finger bones. Each finger is made up of three phalanges: proximal, middle, and distal, while the thumb is composed of a proximal phalanx and a distal phalanx. Flexing of the phalanges is enabled by hinge joints, as well as by a series of muscles and tendons that run from the forearm through the wrist and hand.
CONTACT Y PLASTIC AND RECONSTRUCTIVE SURGERY
Dr. Asaf Yalif, lead surgeon at Y Plastic and Reconstructive Surgery, is uniquely qualified to provide advanced, cutting-edge surgical treatment options for degenerative or traumatic hand and upper extremity issues. The only surgeon in the Atlanta area specializing in the rare combination of hand and plastic surgery, Dr. Yalif is triple Board Certified in Plastic Surgery, Hand Surgery, and Orthopedic Surgery. His unique perspective on soft tissue, joint, and bone-related conditions of the hand, fingers, wrist, and elbow enables him to offer a variety of medical and surgical options unavailable at traditional orthopedic practices. Y Plastic and Reconstructive Surgery is a friendly, welcoming boutique medical practice where cutting-edge surgical techniques are coupled with an emphasis on the patient experience; whether you are dealing with a traumatic injury or a long-standing degenerative disease, Dr. Yalif will take the time to listen to your concerns, answer your questions, and work closely with you to develop a personalized treatment plan tailored to ensure that your hands can work as hard as you do!
Y Plastic and Reconstructive Surgery has offices conveniently located in Atlanta, Roswell, and Woodstock, Georgia. If you would like more information about potential surgical or non-surgical options for hand and upper extremity injury, disease, and/or rejuvenation, or are interested in learning more about Dr. Yalif and Y Plastic and Reconstructive Surgery, we encourage you to contact us today for an initial consultation. We look forward to hearing from you!