Wrist

The wrist is the complex region where the hand meets the forearm, enabling a wide range of movements while providing stability. It consists of the distal ends of the radius and ulna, the articular disc, and eight carpal bones arranged in two rows. The proximal row includes the scaphoid, lunate, triquetrum, and pisiform; the distal row comprises the trapezium, trapezoid, capitate, and hamate. The radiocarpal joint forms the main articulation between the distal radius and the proximal carpal row, while the midcarpal joints lie between the two carpal rows and contribute to wrist motion.

Stability and motion are governed by ligaments, including the dorsal and palmar radiocarpal ligaments and the radial and ulnar collateral ligaments, along with numerous intercarpal ligaments. The wrist is traversed by extensor and flexor tendons, and its innervation includes branches of the median, ulnar, and radial nerves, providing motor and sensory function to the hand and wrist. Vascular supply comes from the radial and ulnar arteries, with contributions to the carpal arches.

Movements of the wrist include flexion, extension, radial and ulnar deviation, as well as combined circumduction. Clinically, wrist injuries are common and range from fractures to soft-tissue conditions. Distal radius fractures, including Colles fractures, and scaphoid fractures are frequent and can threaten blood supply to a fragment. Carpal tunnel syndrome results from median nerve compression at the wrist, while De Quervain’s tenosynovitis involves the tendons at the first dorsal compartment. Imaging typically begins with radiographs; MRI or CT may be used for detailed assessment.