Handleden

Handleden, or the wrist, is the complex joint that connects the forearm to the hand. It enables a wide range of hand movements while distributing loads during daily activities. The wrist comprises the radiocarpal joint, the distal radioulnar joint, and the midcarpal joints. The carpal bones form two rows: proximal (scaphoid, lunate, triquetrum, pisiform) and distal (trapezium, trapezoid, capitate, hamate).

The radiocarpal joint primarily links the distal radius with the proximal carpal row and allows flexion, extension, and some radial and ulnar deviation. The distal radioulnar joint stabilizes the forearm’s rotational movement. Ligaments provide stability around the wrist; important examples include the radial and ulnar collateral ligaments, and the volar (palmar) and dorsal radiocarpal ligaments, along with intercarpal ligaments that unite the carpal bones.

Nerves supplying the wrist originate mainly from the median, ulnar, and radial nerves, contributing to sensation in the hand and motor control of some wrist and finger movements. Blood supply comes from branches of the radial and ulnar arteries.

Injuries and conditions commonly affect the handleden. Fractures of the distal radius (such as Colles fractures) and scaphoid fractures are frequent. Carpal dislocations, ligament sprains, and degenerative osteoarthritis may occur with aging or overuse. Carpal tunnel syndrome involves compression of the median nerve within the carpal tunnel and is a notable nerve-entrapment condition. Inflammation of the tendons around the wrist, such as de Quervain’s tenosynovitis, can cause pain with thumb movement.

Diagnosis typically uses imaging like X-rays, with MRI or ultrasound for further detail. Treatment ranges from immobilization and physical therapy to surgical intervention for complex injuries.