The structure of the nail phalanx. Fracture of the marginal base of the nail phalanx of the hand. Dislocations of the phalanges of the fingers: causes, consequences, methods of treatment. Structural features of the human hand

rice. 127 Upper limb bones ( ossa membri superioris) right; front view.

Finger bones (phalanges), ossa digitorum (phalanges) (see Fig. , , , , ), are presented phalanges, phalanges related in form to long bones. The first, thumb, finger has two phalanges: proximal, phalanx proximalis, and distal, phalanx distalis. The rest of the fingers have middle phalanx, phalanx media. In each phalanx, a body and two epiphyses are distinguished - proximal and distal.

body, each phalanx is flattened from the front (palmar) side. The surface of the body of the phalanx is limited on the sides by small combs. On it is nutrient hole, continuing into the distally directed nutrient channel.

Superior, proximal, end of phalanx, or base, basis phalangis, thickened and has articular surfaces. The proximal phalanges articulate with the bones of the metacarpus, and the middle and distal phalanges are interconnected.

The lower, distal, end of the 1st and 2nd phalanges has head of the phalanx, caput phalangis.

At the lower end of the distal phalanx, on the back side, there is a slight roughness - tuberosity of the distal phalanx, tuberositas phalangis distalis.

In the area of ​​the metacarpophalangeal joints of the I, II and IV fingers and the interphalangeal joint of the I finger on the palmar surface, in the thickness of the muscle tendons, sesamoid bones, ossa sesamoidea.

rice. 151. Bones of the hand, right (X-ray). 1 - radius; 2 - styloid process of the radius; 3 - lunate bone; 4 - navicular bone; 5 - trapezoid bone; 6 - trapezoid bone; 7-1 metacarpal; 8 - sesamoid bone; 9 - proximal phalanx of the thumb; 10 - distal phalanx of the thumb; 11 - II metacarpal bone; 12 - proximal phalanx of the index finger; 13 - base of the middle phalanx of the index finger; 14 - distal phalanx of the index finger; 15 - capitate bone; 16 - hook of the hook-shaped bone; 17 - hook-shaped bone; 18 - pisiform bone; 19 - trihedral bone; 20 - styloid process of the ulna; 21 - head of the ulna.

All fingers are formed by 3 phalanges, called the main, middle and nail. The only exception is the thumbs, they consist of 2 phalanges. The thickest phalanges of the fingers form the thumbs, and the longest form the middle fingers.

Human hand and foot as a result of evolution

Our distant ancestors were vegetarians. Meat was not part of their diet. The food was low-calorie, so they spent all the time on the trees, getting food in the form of leaves, young shoots, flowers and fruits. The fingers and toes were long, with a well-developed grasping reflex, thanks to which they were kept on the branches and deftly climbed the trunks. However, the fingers remained inactive in a horizontal projection. The palms and feet did not open well into a plane with widely spaced fingers. The opening angle did not exceed 10-12°.

At some point, one of the primates tasted meat and found that this food is much more nutritious. He suddenly had time to consider the world around him. He shared his discovery with his brothers. Our ancestors became carnivores and descended from the trees to the ground and rose to their feet.

However, the meat had to be butchered. Then man invented the axe. Man is actively using modified versions of the chopped and today. In the process of making this tool and working with it, people began to change their fingers. On the arms they became mobile, active and strong, but on the legs they shortened and lost their mobility.

By prehistoric times, the fingers and toes of man have gained almost modern look. The angle of opening of the fingers at the palm and on the foot reached 90°. People have learned to perform complex manipulations, play musical instruments, draw, draw, engage in circus art and sports. All these activities were reflected in the formation of the skeletal base of the fingers.

Development became possible due to the special structure of the human hand and foot. She, speaking technical language, all "hinged". Small bones are connected by joints in a single and harmonious form.

Feet and palms have become mobile, they do not break when making reversal and eversion movements, arching and torsion. With fingers and toes, a modern person can press, open, tear, incise and perform other complex manipulations.

Anatomy and structure of the finger

Anatomy is a fundamental science. The structure of the hand and wrist is a topic that is of interest not only to physicians. Knowledge of it is necessary for athletes, students and other categories of people.

In humans, fingers and toes, despite noticeable external differences, have the same phalanx structure. At the base of each finger are long tubular bones called phalanges.

The toes and toes are the same in structure. They consist of 2 or 3 phalanges. Its middle part is called the body, the bottom is called the base or proximal end, and the top is called the block or distal end.

Each finger (except the thumb) consists of 3 phalanges:

• proximal (main);
• middle;
• distal (nail).

The thumb consists of 2 phalanges (proximal and nail).

The body of each phalanx of the fingers has a flattened upper back and small lateral ridges. The body has a nutritional opening that passes into a canal directed from the proximal to the distal end. The proximal end is thickened. It has developed articular surfaces that provide connection with other phalanges and with the bones of the metacarpus and foot.

The distal end of the 1st and 2nd phalanges has a head. On the 3rd phalanx, it looks different: the end is pointed and has a bumpy, rough surface on the back. The articulation with the bones of the metacarpus and foot is formed by the proximal phalanges. The remaining phalanges of the fingers provide a reliable connection of the bones of the finger to each other.

Phalangeal deformities and their causes

Sometimes a deformed phalanx of a finger becomes the result of pathological processes occurring in the human body.

If round thickenings appear on the phalanges of the fingers and the fingers become like drumsticks, and the nails turn into sharp claws, then the person probably has diseases internal organs, which may include:

• heart defects;
• impaired lung function;
• infective endocarditis;
• diffuse goiter, Crohn's disease (severe disease of the gastrointestinal tract);
• lymphoma;
• cirrhosis of the liver;
• esophagitis;
• myeloid leukemia.

If such symptoms appear, you should immediately consult a doctor, because in a neglected state, these diseases can become a serious threat to your health and even life. It happens that the deformation of the phalanges of the fingers and toes is accompanied by excruciating, pulling pains and a feeling of stiffness in the hand and foot. These symptoms indicate that the interphalangeal joints are affected.

Diseases affecting these joints include:

• deforming osteoarthritis;
• gouty arthritis;
• rheumatoid arthritis;
• psoriatic arthritis.

In no case should you self-medicate, because due to illiterate therapy, you can completely lose the mobility of your fingers, and this will greatly reduce the quality of life. The doctor will prescribe examinations that will reveal the causes of the disease.

Determining the causes will allow you to make an accurate diagnosis and prescribe a treatment regimen. In the case of strict adherence to all the recommendations of the physician in such diseases, the prognosis will be positive.

If painful bumps appear on the phalanges of the fingers, then you are actively developing gout, arthritis, arthrosis, or accumulated salt deposits. A characteristic feature of these diseases is considered to be a seal in the area of ​​\u200b\u200bcones. A very disturbing symptom, because it is such a thickening that leads to immobilization of the fingers. With such a clinic, you should go to the doctor so that he prescribes a therapy regimen, makes up a set of gymnastic exercises, prescribes massage, applications and other physiotherapeutic procedures.

Injuries of joints and bone structures

Who among us hasn't pressed our fingers against doors, hit a nail with a hammer, or dropped some heavy object on our feet? Quite often, such incidents end in fractures. These injuries are very painful. They are almost always complicated by the fact that the fragile body of the phalanx breaks into many fragments. Sometimes the cause of a fracture can be a chronic disease that destroys the bone structure of the phalanx. These diseases include osteoporosis, osteomyelitis and other severe tissue damage. If you have a high risk of getting such a fracture, then you should take care of your arms and legs, because the treatment of such phalangeal fractures is troublesome and expensive.

Traumatic fractures according to the nature of the damage can be closed and open (with traumatic ruptures and tissue damage). After a detailed examination and X-ray, the traumatologist determines whether the fragments have shifted. Based on the results obtained, the attending physician determines how he will treat this injury. With open fractures, victims always go to the doctor. After all, the spectacle of such a fracture is very unsightly and frightens a person. But closed fractures of the phalanges often try to endure. You have a closed fracture if, after the injury, you experience:

• pain on palpation (touch);
• swelling of the finger;
• restriction of movements;
• subcutaneous hemorrhage;
• finger deformity.

Go to a traumatologist immediately and get treated! Dislocations of the phalanges, injuries of tendons, ligaments can be combined with closed fractures of the fingers, so you cannot cope without the help of a specialist.

Rules for the provision of first aid

If the phalanx is damaged, even if it is just a bruise, it is worth immediately applying a splint or a tight polymer bandage. As a tire, you can use any dense plate (wooden or plastic). Pharmacies today sell latex splints that fix a split bone well. You can use the adjacent healthy finger together. To do this, firmly bandage them together or glue them with a band-aid. This will immobilize the injured phalanx and make it possible to calmly work with the hand. This will also help prevent the bone fragments from moving.

Conservative treatment (wearing tight bandages and plaster) of fractures lasts about 3-4 weeks. During this time, the traumatologist conducts x-rays twice (on days 10 and 21). After removing the plaster for six months, active development of the fingers and joints is carried out.

The beauty of the hands and feet is determined by the correct forms of the phalanges of the fingers. You need to take care of your hands and feet regularly.

Phalanges of fingers

The phalanges of the human fingers have three parts: proximal, main (middle) and final (distal). On the distal part of the nail phalanx there is a well-marked nail tuberosity. All fingers are formed by three phalanges, called the main, middle and nail. The only exception is the thumbs - they consist of two phalanges. The thickest phalanges of the fingers form the thumbs, and the longest form the middle fingers.

Structure

The phalanges of the fingers are short tubular bones and look like a small elongated bone, in the form of a semi-cylinder, with a convex part facing the back of the hand. At the ends of the phalanges are the articular surfaces that take part in the formation of interphalangeal joints. These joints are block-shaped. They can perform extensions and flexions. The joints are well reinforced with collateral ligaments.

The appearance of the phalanges of the fingers and the diagnosis of diseases

In some chronic diseases of the internal organs, the phalanges of the fingers are modified and take on the appearance of "drumsticks" (a spherical thickening of the terminal phalanges), and the nails begin to resemble "watch glasses". Such modifications are observed in chronic lung diseases, cystic fibrosis, heart defects, infective endocarditis, myeloid leukemia, lymphoma, esophagitis, Crohn's disease, liver cirrhosis, diffuse goiter.

Fracture of the phalanx of the finger

Fractures of the phalanges of the fingers most often occur as a result of a direct blow. Fracture of the nail plate of the phalanges is usually always shrapnel.

Clinical picture: the phalanx of the fingers hurts, swells, the function of the damaged finger becomes limited. If the fracture is displaced, then the deformation of the phalanx becomes clearly visible. With fractures of the phalanges of the fingers without displacement, stretching or displacement is sometimes misdiagnosed. Therefore, if the phalanx of the finger hurts and the victim associates this pain with an injury, then an x-ray examination (fluoroscopy or radiography in two projections) should be required, which allows you to make the correct diagnosis.

Treatment of a fracture of the phalanx of the fingers without displacement is conservative. An aluminum splint or plaster cast is applied for three weeks. After that, physiotherapy treatment, massage and classes are prescribed. physical therapy. Full mobility of the injured finger is usually restored within a month.

In case of a fracture of the phalanges of the fingers with a displacement, bone fragments are compared (reposition) under local anesthesia. Then a metal splint or plaster cast is applied for a month.

In case of a fracture of the nail phalanx, it is immobilized with a circular plaster bandage or adhesive plaster.

Phalanges of fingers hurt: causes

Even the smallest joints in the human body - the interphalangeal joints - can be affected by diseases that impair their mobility and are accompanied by excruciating pain. Such diseases include arthritis (rheumatoid, gouty, psoriatic) and deforming osteoarthritis. If these diseases are not treated, then over time they lead to the development of a pronounced deformation of the damaged joints, a complete violation of their motor function and atrophy of the muscles of the fingers and hands. Despite the fact that the clinical picture of these diseases is similar, their treatment is different. Therefore, if you have pain in the phalanges of the fingers, then you should not self-medicate. Only a doctor, after conducting the necessary examination, can make the correct diagnosis and, accordingly, prescribe the necessary therapy.

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Phalanges of fingers

Having studied the meaning of nails, proceed to the examination of the phalanges of the fingers.

The phalanges of the fingers are of particular value - both individually and all together. In fact, they provide us with reliable clues to a person's professional inclinations, and they also tell us about the most striking character traits.

Each finger has three segments. The lowest part, the one closest to the palm, is considered the third phalanx, the middle one is the second, and the upper one is the first.

If the lower phalanx of each finger is the longest compared to the other two, special attention should be paid to this. These segments are associated with animal instincts and physical addictions. If they dominate, their owner is predisposed to live in a world governed by physical needs. He has no intellectual inclinations, nor is he endowed with any spiritual values. He usually has a healthy and strong physique, and nature itself has made him suitable for hard work. It can be found in all areas of our lives where physical strength and a good physique are required. He is not too diligent and cannot hold any position of responsibility. His character usually corresponds to farm work or any type of work that does not require special qualifications. In the factory, in the office or in the field, he can perform work that does not require a high degree of intelligence, but is associated with activities related to physical endurance, the ability to withstand great stress and a healthy physique. He can also be seen in low-skilled jobs - truck driver, packer, scavenger, etc. He is hardworking, but he needs sensitive guidance and directives. Being engaged in measured, routine work, he can perform his duties quite well.

He loves physical comfort and usually has an excellent appetite. He enjoys gymnastics and outdoor life, and usually finds hobbies for himself that give an outlet to his physical energy.

Since he tends to show herd mentality, gets along well with his own kind and, according to his own standard of living and intelligence, he usually turns out to be a good citizen, master and friend. Loves family life and home comfort, hardly survives loneliness.

Although he is often rude and blunt in his manner, he can also be kind and have a great sense of humor. As long as his physical comfort is satisfied, he is happy.

If all the middle phalanges are the longest, their owner, although inclined to enjoy normal physical comfort and good food, engages in activities that require a higher level of intelligence, training and education. His choice of work and public relations is predetermined by an intellectual approach to things. Fingers, the second phalanges are the longest, commonly found in professionals, businessmen, scientists, doctors, journalists, in fact, a whole range of people who work predominantly with the head rather than with the hands.

One of the most interesting features of the owner of such fingers is that he is smart, active, well trained and inclined to study and gain new knowledge. He constantly adds something new to the already accumulated knowledge and experience in his particular field of activity.

His values ​​are just as healthy and constructive. He usually adheres to accepted norms of behavior both socially and professionally. He is receptive, observant and believes that you can create your prestige, social status and earn material values. He can be a diligent worker, although he does not devote all his time to work as such. He can be very fond of his home, be a family man and a useful and conscientious citizen.

If the upper phalanges of all fingers are the longest, their owner is less inclined towards physical things. This is an indicator of idealism and an innate need for devotion to spiritual and moral things. Such a person is sensitive, prone to metaphysics and strives to comprehend any school of thought, philosophy, ethics or religion to which he could devote his entire existence.

Without being too practical, he is very intelligent and receptive. He is not inclined to notice his own impracticality, and his ideals so absorb his personality that he often becomes a kind of symbol of a metaphysical and spiritual orientation. Such a person is excellently suited for missionary work or for such academic interests as may be related to moral philosophy or reform work.

He too often neglects physical comfort and as a result becomes isolated from society.

Even if he does not retire and continues to live in ordinary conditions, among the hustle and bustle, he still lives like a hermit. However, he can have a profound effect on those with whom he associates.

He does not give free rein to his appetite and can be quite indifferent to the delicacies on the table or to personal intimate bonds of an emotional nature. He will always strive for simplicity, usually he is ascetic in everything that concerns the physical needs of a person.

Not being too strong man physically, he tends to show insufficient stamina and energy and often suffers from insufficient or malnutrition. Very sensitive in nature, he is prone to nervous breakdowns. But with proper care, he can live long enough and maintain his health in perfect order.

Phalanx (anatomy)

body(corpus), the proximal end is the base, basis, and the distal end is the block, trochlea. There is a nail tuberosity at the distal end of the nail phalanx.

basic, middle and nail. The phalanges of the lower limb are shorter than the phalanges of the upper limb. On the hand, the longest phalanx is the main phalanx of the third finger, and the thickest is the main phalanx of the thumb. Each phalanx is an elongated bone, having in the middle part (diaphysis) the shape of a half-cylinder, the flat part of which is facing the palmar, and the convex part is facing the back. The end parts of the phalanx (epiphyses) bear the articular surfaces.

cetaceans

In cetaceans, the number of phalanges is much larger. This is explained by the fact that their diaphyses and epiphyses of the phalanges ossify separately and form, as it were, independent phalanges.

Birds

On the hind limbs of birds there can be from two to four fingers. In four-fingered forms, the number of phalanges is usually 2-3-4-5, counting from the inner finger outward, in three-fingered forms 3-4-5. A number of exceptions are known: in petrels 1-3-4-5; in nightjars 2-3-4-4, in some swifts 2-3-3-3.

reptiles

The number of phalanges in reptiles is small, but not constant. However, on the hind limbs of the fossil animal group (Theromorpha), considered the ancestors of mammals, the number of phalanges was the same as in mammals. In aquatic fossil groups of sauropterygia (Sauropterygia) and ichthyopterygia (Ichtyopterygia), which had a fin-like limb resembling that of cetaceans, the number of phalanges was very significant, as in cetaceans. This circumstance indicates that a large number of phalanx serves as an adaptation of the limb to the aquatic lifestyle [ source not specified 2713 days] .

Amphibians

At the rodent Pedets

Phalanx of fingers

Phalanges (Greek φάλαγξ) - short tubular bones that form the skeleton of the fingers of the limbs of vertebrate animals, including humans.

Structure

The phalanx is a tubular bone, the middle part is called body(corpus), the proximal end is the base, basis, and the distal end is the block, trochlea.

Man

In humans, each finger, except for the thumb, consists of three phalanges, and the thumb of two. These three phalanges are called basic, middle and nail. The phalanges of the lower limb are shorter than the phalanges of the upper limb. On the hand, the longest phalanx is the main phalanx of the third finger, and the shortest and thickest is the main phalanx of the thumb. Each phalanx is an elongated bone, having in the middle part (diaphysis) the shape of a half-cylinder, the flat part of which is facing the palmar, and the convex part is facing the back. The end parts of the phalanx (apophyses) bear the articular surfaces.

In medicine, the following terms are used for the phalanges of the hand and foot:

• proximal (main) phalanx (phalanx proximalis);
• middle phalanx (phalanx media);
• distal (nail) phalanx (phalanx distalis).

Other animals

cetaceans

In cetaceans, the number of phalanges is much larger. This is due to the fact that their diaphyses and apophyses of the phalanges ossify separately and form, as it were, independent phalanges.

Birds

On the hind limbs of birds there can be from two to four fingers. In four-fingered forms, the number of phalanges is usually 2-3-4-5, counting from the inner finger outward, in three-fingered forms 3-4-5. A number of exceptions are known: in petrels 1-3-4-5; in nightjars 2-3-4-4, in some swifts 2-3-3-3.

The two-toed African ostrich, which has preserved the third and fourth fingers, has 4 and 5 phalanges, respectively.

On the wing, the first and third fingers are usually from one phalanx, and the second from two, but here there are exceptions. So, in diurnal predators, chicken, American ostrich, the number of phalanges, counting from the inner finger outward, is 2-2-1; in ducks, bustards and others 2-3-1; the African ostrich has 2-3-2; in cassowary and kiwi - only one finger of 3 phalanges.

reptiles

The number of phalanges in reptiles is small, but not constant. However, on the hind limbs of the fossil animal group (Theromorpha), considered the ancestors of mammals, the number of phalanges was the same as in these latter. In the aquatic fossil groups of Sauropterygia and Ichtyopterygia, which had a fin-like limb resembling that of cetaceans, the number of phalanges was very significant, as in these latter. This circumstance, of course, indicates the importance of an increase in the number of phalanges as an adaptation of the limb to an aquatic lifestyle.

Amphibians

The number of phalanxes is also variable in amphibians. In most cases, in tailed amphibians (Urodela), the fingers have two phalanges, except for the fourth, which has three, and in tailless (Anura) the fifth finger also has three phalanges. Additional fingers usually consist of one phalanx, although sometimes two.

At the rodent Pedets the so-called praepollex (prae - rudimentary, pollex - thumb) consists of two phalanges and carries a claw. If we take the first toe of amphibians for praepollex and praehallux (hallux - big toe), then it also turns out to be consisting of two phalanges.

findings

These figures can be summarized in a table:

Wikimedia Foundation. 2010 .

See what the "Phalanx of fingers" is in other dictionaries:

PHALANX - (Greek). 1) row, system; among the ancient Greeks: a special formation of infantry. 2) a poisonous insect, from the class of arachnids, found in Persia, the Caucasus, and other places. Vocabulary foreign words included in the Russian language. Chudinov A.N., 1910. PHALANX 1) ... Dictionary of foreign words of the Russian language

Phalanx (anatomy) - This term has other meanings, see Phalanx. Bones of the human left hand, dorsal (dorsal) surface ... Wikipedia

Phalanx - I f. 1. Each of the three short tubular bones that form the skeleton of the fingers of the limbs in humans and vertebrates. 2. see also. phalanx II. 1. The battle formation of armed infantry, which is a closed formation in several ranks (in ... Modern dictionary Russian language Efremova

Phalanx - I f. 1. Each of the three short tubular bones that form the skeleton of the fingers of the limbs in humans and vertebrates. 2. see also. phalanx II. 1. The battle order of the armed infantry, which is a closed formation in several ranks (in ... Modern explanatory dictionary of the Russian language Efremova

Phalanx - I f. 1. Each of the three short tubular bones that form the skeleton of the fingers of the limbs in humans and vertebrates. 2. see also. phalanx II. 1. The battle order of the armed infantry, which is a closed formation in several ranks (in ... Modern explanatory dictionary of the Russian language Efremova

Phalanx - I f. 1. Each of the three short tubular bones that form the skeleton of the fingers of the limbs in humans and vertebrates. 2. see also. phalanx II. 1. The battle order of the armed infantry, which is a closed formation in several ranks (in ... Modern explanatory dictionary of the Russian language Efremova

PHALANX - [from Greek. phalanx (phalangos) joint] anat. each of the short tubular bones, forming the skeleton of the fingers of the limbs in most vertebrates and humans (see also Hand, Foot) ... Psychomotor: a reference dictionary

Distal phalanx - (phalanx distalis) Distal phalanx (phalanx distalis) Bones of the foot (ossa pcdis). Top view... Atlas of human anatomy

Proximal phalanx - (phalanx proximalis) Proximal phalanx (phalanx proximalis) Bones of the foot (ossa pcdis). View from above ... Atlas of human anatomy

what are the phalanges of the fingers on the hand?

In humans, each finger, except for the thumb, consists of three phalanges, and the thumb of two. These three phalanges are called the main, middle and nail. The phalanges of the lower limb are shorter than the phalanges of the upper limb. On the hand, the longest phalanx is the main phalanx of the third finger, and the thickest is the main phalanx of the thumb. Each phalanx is an elongated bone, having in the middle part (diaphysis) the shape of a half-cylinder, the flat part of which is facing the palmar, and the convex part is facing the back. The end parts of the phalanx (epiphyses) bear the articular surfaces.

In medicine, the following terms are used for the phalanges of the hand and foot:

proximal (main) phalanx (phalanx proximalis);

middle phalanx (phalanx media);

distal (nail) phalanx (phalanx distalis).

Finger bones (phalanges).

The bones of the fingers (phalanges), ossa digitorum (phalanges), are represented by phalanges, phalanges, related in shape to long bones. The first, thumb, finger has two phalanges: proximal, phalanx proximalis. and distal, phalanx distalis. The remaining fingers also have a middle phalanx, phalanx media. In each phalanx, a body and two epiphyses are distinguished - proximal and distal.

The body, corpus, of each phalanx is flattened from the front (palmar) side. The surface of the body of the phalanx is limited on the sides by small combs. It has a nutritional opening that continues into a distally directed nutrient canal.

The upper, proximal, end of the phalanx, or base, basin phalangis, is thickened and has articular surfaces. The proximal phalanges articulate with the bones of the metacarpus, and the middle and distal phalanges are interconnected.

The lower, distal, end of the 1st and 2nd phalanges has a phalanx head, caput phalangis.

At the lower end of the distal phalanx, on the back side, there is a slight roughness - tuberosity of the distal phalanx, tuberositas phalangis distalis.

In the area of ​​the metacarpophalangeal joints of the 1st, 2nd and 5th fingers and the interphalangeal joint of the 1st finger on the palmar surface, in the thickness of the muscle tendons, there are sesamoid bones, ossa sesamoidea.

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Fractures of the phalanx of the finger

Moisov Adonis Alexandrovich

Orthopedic surgeon, doctor of the highest category

Moscow, Balaklavsky prospect, 5, Chertanovskaya metro station

Moscow, st. Koktebelskaya 2, bldg. 1, metro station "Dmitry Donskoy Boulevard"

Moscow, st. Berzarina 17 bldg. 2, metro station "October field"

In 2009 he graduated from the Yaroslavl State Medical Academy with a degree in general medicine.

From 2009 to 2011, he underwent clinical residency in traumatology and orthopedics at the Clinical Emergency Hospital named after. N.V. Solovyov in Yaroslavl.

From 2011 to 2012, he worked as a traumatologist-orthopedist at the emergency hospital No. 2 in Rostov-on-Don.

Currently works in a clinic in Moscow.

2012 - training course in foot surgery, Paris (France). Correction of deformities of the forefoot, minimally invasive operations for plantar fasciitis (heel spur).

February 2014 Moscow - II Congress of Traumatologists and Orthopedists. “Traumatology and orthopedics of the capital. Present and Future".

November 2014 - Advanced training "Application of arthroscopy in traumatology and orthopedics"

May 14-15, 2015 Moscow - Scientific and practical conference with international participation. "Modern Traumatology, Orthopedics and Disaster Surgeons".

2015 Moscow - Annual international Conference"Arthromost".

Fracture of the phalanx of the finger

Our fingers perform very delicate, coordinated movements and disruption of these movements can have a huge impact on daily and professional activities. To maintain the full function of the hand, it is very important that all finger fractures are evaluated by a doctor to determine the appropriate treatment. If you think that a broken finger is a minor injury, then you are seriously mistaken. Without proper treatment, a finger fracture can cause serious problems: limited finger flexion (contracture), pain with minor exertion, reduced grip, whether it is a fracture of the nail or the main phalanx of the finger.

The human hand is formed by 27 bones:

• 8 bones of the wrist;
• 5 metacarpals;
• The 14 bones that make up the fingers are called phalanges. The first finger has only two phalanges: proximal and distal. Unlike the rest of the fingers, which consist of three phalanges: proximal, middle and distal.

Fractures of the metacarpal bones of the hand account for 30% of all hand fractures in adults.

Types of finger fracture

• Traumatic fractures are damage to the bone of the finger due to trauma.
• Pathological fracture - a fracture of the finger in the zone of pathological restructuring (affected by any disease - osteoporosis, tumor, osteomyelitis, etc.) Osteoporosis is the most common cause of a pathological fracture.

• Open fractures (with skin damage)

• Fractures without displacement of fragments
• Displaced fractures.

Signs and symptoms of a broken finger

Signs of a broken finger include:

• Pain on palpation (touch);
• Swelling of the finger;
• Restriction of movements;
• Subcutaneous hemorrhage;
• Finger deformity;

Finger fractures can be associated with injuries such as:

Dislocation of the phalanx, damage to the tendons, damage to the ligaments. This can complicate treatment.

Diagnosis and treatment of a fracture of the phalanx of the finger

If you have symptoms of a fracture of the phalanx of the finger, you should contact the emergency room at the place of residence. Where, after examination, radiography will be performed in two projections of the damaged segment. The doctor must determine not only the location of the fracture, but also the type. The bone can be broken in several directions. A fracture of the phalanx can be transverse, in a spiral, into several fragments, or multi-comminuted, i.e. collapse completely.

Treatment for finger fractures depends on three main factors:

• First, is the joint affected?
• Second, "stable" or "unstable" fracture?
• Third, is the finger deformed?

If the fracture involves a joint (intra-articular fracture), it is important to make sure that the articular surface is not destroyed and the fragments have not separated, i.e. no offset. In this case, you can do without surgery.

Second, it is important to define a "stable" or "unstable" fracture. Fracture stability can be determined by x-ray. A fracture is considered unstable if the fragments are displaced, or the nature of the fracture is such that even after correct reposition (elimination of the displacement), the fragments can move over time and remain in a displaced position. The anatomy will naturally be disturbed, which can affect the function of the finger and hand.

The doctor must determine whether there is a shortening of the segment or whether the distal fragment is rotated (turned about its axis). The fingers on the injured hand should line up and look the same as on the healthy hand.

If the articular surfaces are destroyed or the fragments are displaced, if the fracture is unstable, if there is a deformity that needs to be corrected, then an operation is necessary to restore the normal anatomy of the hand and preserve function after the fusion of the finger fracture.

Conservative treatment

In case of a finger fracture without displacement, the following assistance is provided: the damaged segment of the hand is fixed with a plaster splint or polymer bandage, which is lighter and stronger than plaster.

Sometimes an adjacent finger is used as a splint, firmly fixing them together with a band-aid. This makes it possible to work with a brush, bend fingers without fear that bone fragments will move.

If, after reposition, the fragments have shifted, there is instability of the fracture, a multi-comminuted fracture or deformity cannot technically be eliminated, then an operation is necessary in this case. With the help of metal structures, fragments can be fixed in the correct position until the fracture is completely healed. If the fracture is displaced, the doctor should try to repair the displaced fragments without surgery. This is performed under local or conduction anesthesia. If the displacement is not eliminated, then there are indications for surgery. After the displacement is eliminated, the finger is fixed with a plaster splint or polymer bandage to prevent secondary displacement. Fractures of the phalanges grow together in 3-4 weeks. During these three weeks, control (repeated) radiographs are taken after 10 and 21 days to make sure that there is no secondary displacement in the cast. After that, the plaster is removed and the active development of the joints of the hand begins.

Surgery

Depending on the type and severity of the fracture of the phalanx of the finger, an operation may be required - osteosynthesis (osteo - bone, synthesis - create, restore), due to which anatomical restoration of damaged structures is achieved.

During the operation, open reposition of fragments (comparison of broken parts) and fixation with metal structures takes place. And for each fracture, an appropriate metal structure or a combination of them is selected:

The advantages of this method: simplicity and short manipulation time, no incision and, as a result, a postoperative scar.

Cons: one end of the pin remains above the skin so that the pin can be removed after the fracture has healed; the risk of infection of the wound and the penetration of infection into the fracture area; long-term wearing of a plaster cast for 1 month; the inability to start early development of the joints of the hand, resulting in the risk of irreversible contracture (lack of movement in the joint) of the injured finger.

Osteosynthesis with plate and screws:

During the operation, access to the fracture site is performed, the fragments are compared and fixed with a plate and screws. The wound is sutured. A sterile dressing is applied. Dressings are performed every other day. Put on the stitches are removed.

Advantages of this method: complete restoration of the anatomy of the phalanx; the possibility of early development of the joints of the hand; a plaster cast is applied for only 2 weeks.

Cons: as after any operation, a small scar remains.

With deformation of the fingers in fractures in the article Dupuytren's contracture.

Do not self-medicate!

Only a doctor can make a diagnosis and prescribe the right treatment. If you have any questions, you can call by phone or ask a question by e-mail.

On closer examination, the structure, like any other department of our musculoskeletal system, is quite complex. It is made up of three main structures: bones, muscles, and ligaments that hold the bones together. There are three sections in the hand, namely, the wrist, fingers, and metacarpus.

In this article, we will take a closer look at the hand: the joints of the hand. Let's start with a description of the bones in its various departments.

wrist bones

Since the hands must perform fairly precise and intricate movements, the structure of the bones of the hand is also extremely complex. In the wrist - 8 small bones of irregular shape, arranged in two rows. In the figure below you can see the structure of the right hand.

The proximal row forms an articular surface convex to the radius. It includes bones, if you count from the fifth to the thumb: pisiform, trihedral, lunate and scaphoid. The next row is the distal one. It connects to an irregularly shaped proximal joint. The distal row consists of four bones: trapezius, polygonal, capitate and hamate.

Metacarpal bones

This department, consisting of 5 tubular ones, also demonstrates the intricate structure of the hand. The skeleton of these tubular bones is complex. Each of them has a body, base and head. The 1st finger is shorter than the others and is massive. The second metacarpal is the longest. The rest decrease in length as they move away from the first and approach the ulnar edge. The bases of the aforementioned metacarpus bones articulate with the bones that form the wrist. The first and fifth metacarpals have bases with saddle-shaped articular surfaces, the others are flat. The heads of the metacarpal bones, which have an articular surface (hemispherical), articulate with the proximal digital phalanges.

Finger bones

Each finger, with the exception of the first, which consists of only two phalanges and does not have a middle one, has 3 phalanges: distal, proximal and middle (intermediate). The shortest - distal; proximal - the longest. At the distal end, there is a head of the phalanx, and at the proximal end, its base.

Sesamoid bones of the hand

In the thickness of the tendons, in addition to these bones, there are sesamoid, located between the proximal phalanx of the thumb and its metacarpal bone. There are also unstable sesamoid bones. They are located between the proximal phalanges of the fifth and second fingers and their metacarpals. Usually sesamoid bones are located on the palmar surface. But sometimes they can be found on the back. The pisiform bone also belongs to the above species. The sesamoid bones and their processes increase the leverage of the muscles attached to them.

We examined the structure of the hand and the bones of the hand, now we turn to the ligamentous apparatus.

wrist joint

It is made up of the radius and the bones of the proximal row of the wrist: trihedral, lunate and navicular. The ulna is complemented by the articular disc and does not reach the wrist joint. The main role in the formation of the elbow joint plays Whereas the wrist - radial. The wrist joint is elliptical in shape. It allows abduction, adduction of the hand, flexion and extension. A small passive rotational movement (by 10-12 degrees) is also possible in this joint, but is carried out due to the elasticity of the articular cartilage. Through soft tissues, it is easy to detect the gap of the wrist joint, which is palpable from the ulnar and radial sides. With the ulna, you can feel the depression between the triquetral bone and the head of the ulna. On the radial side - a gap between the navicular bone and the lateral styloid process.

The movements of the wrist joint are closely related to the work of the mid-carpal joint, located between the distal and proximal rows. Its surface is complex, irregular in shape. With flexion and extension, the range of mobility reaches 85 degrees. Adduction of the hand in the above-mentioned joint reaches 40 degrees, abduction - 20. The wrist joint can perform circumduction, i.e. Roundabout Circulation.

This joint is reinforced by numerous ligaments. They are located between individual bones, as well as on the lateral, medial, dorsal and palmar surfaces of the wrist. (radial and ulnar) play the most important role. On the ulnar and radial sides, between the bone elevations, there is a flexor retinaculum - a special ligament. In fact, it does not apply to the joints of the hand, being a thickening of the fascia. The flexor retinaculum converts the carpal groove into a canal through which the median nerve and flexor tendons of the fingers pass. We continue to describe the anatomical structure of the hand.

Carpometacarpal joints

They are flat and immobile. The exception is the joint of the thumb. The range of motion of the carpal-metacarpal joints is no more than 5-10 degrees. They have limited mobility, because the ligaments are well developed. Located on the palmar surface, they form a stable palmar ligamentous apparatus that connects the bones of the wrist and metacarpals. There are arcuate ligaments on the hand, as well as transverse and radial ligaments. The capitate bone is central in the ligamentous apparatus, ligaments are attached to it. Palmar developed much better than the back. The dorsal ligaments connect the bones of the wrist. They form thickenings of capsules that cover the joints between these bones. Interosseous are located in the second row of carpal bones.

In the thumb, the carpometacarpal joint is formed by the base of the first metacarpal and polygonal bone. The articular surfaces are saddle-shaped. This joint can perform the following actions: abduction, adduction, reposition (reverse movement), opposition (opposition) and circumduction (circular movement). The volume of grasping movements, due to the fact that the thumb is opposed to all the others, increases significantly. 45-60 degrees is the mobility of the carpometacarpal joint of this finger during adduction and abduction, and during reverse movement and opposition - 35-40.

The structure of the hand: metacarpophalangeal joints

The named joints of the hand are formed by the heads of the metacarpal bones with the participation of the bases of the proximal phalanges of the fingers. They are spherical in shape, have 3 axes of rotation perpendicular to each other, around which extension and flexion, abduction and adduction, as well as circular movements (circumduction) are carried out. Adduction and abduction is possible at 45-50 degrees, and flexion and extension - at 90-100. These joints have collateral ligaments located on the sides that strengthen them. The palmar, or accessory, are located on the palmar side of the capsule. Their fibers are intertwined with the fibers of the deep transverse ligament, which prevents the heads of the metacarpal bones from diverging in different directions.

Interphalangeal joints of the hand

They are block-shaped, and their axes of rotation run transversely. Extension and flexion is possible around these axes. Proximal interphalangeal joints have a flexion and extension volume of 110-120 degrees, distal - 80-90. The interphalangeal joints are very well reinforced thanks to the collateral ligaments.

Synovial, as well as fibrous sheaths of the tendons of the fingers

The extensor retinaculum, like the flexor retinaculum, plays a huge role in strengthening the position of the tendons of the muscles passing under them. This is especially true when the hand is working: when it is extended and flexed. Nature has conceived a very competent structure that finds support in the above-mentioned ligaments from their inner surface. The separation of the tendons from the bones prevents ligaments. This allows for intense work and strong muscle contraction to withstand great pressure.

The reduction of friction and sliding of the tendons going to the hand from the forearm is facilitated by special tendon sheaths, which are bone-fibrous or fibrous channels. They have synovial sheaths. Their largest number (6-7) is located under the extensor retinaculum. The radius and ulna have grooves that correspond to the location of the tendons of the muscles. As well as the so-called fibrous bridges, which separate the channels from each other and pass to the bones from the extensor retinaculum.

Palmar synovial sheaths belong to the flexor tendons of the fingers and hands. The common synovial sheath extends to the center of the palm and reaches the distal phalanx of the fifth finger. Here are the tendons of the superficial and deep flexors of the fingers. The thumb has a long flexor tendon located separately in the synovial sheath and passing to the finger along with the tendon. The synovial sheaths in the palm area are devoid of the tendon of the muscles that go to the fourth, second and third fingers. Only the tendon of the fifth finger has a synovial sheath, which is a continuation of the general one.

Muscles of the hand

In the figure below you can see the muscles of the arm. The structure of the hand is shown here in more detail.

The muscles in the hand are only on the palmar side. They are divided into three groups: middle, thumb and small fingers.

Since the movements of the fingers require great precision, there are a significant number of short muscles in the hand, complicating the structure of the hand. The muscles of the hand of each of the groups will be considered below.

Middle muscle group

It is formed by worm-like muscles, starting from the tendons of the deep flexor of the fingers and attached to the proximal phalanges, or rather their bases, from the second to the fifth finger, if we consider the structure of the hand. These muscles of the hand also come from the dorsal and palmar interosseous, located in the spaces between the bones of the metacarpus, attached to the base of the proximal phalanges. The function of this group is that these muscles are involved in the flexion of the proximal phalanges of these fingers. Thanks to the palmar interosseous muscles, it is possible to bring the fingers to the middle finger of the hand. With the help of the dorsal interosseous, they are diluted to the sides.

Muscles of the thumb

This group forms the eminence of the thumb. These muscles begin near the nearby bones of the metacarpus and wrist. As for the thumb, its short flexor is attached near the sesamoid bone, which is located near the base of the proximal phalanx. The opposing thumb muscle goes to the first metacarpal bone, and the adductor thumb muscle is located on the side of the internal sesamoid bone.

Muscles of the thumb

This group of muscles forms an elevation on the inside of the palm. These include: the abductor of the little finger, the opposing little finger, the short palmar, and the short flexor.

They originate from nearby bones in the wrist. These muscles are attached to the base of the fifth finger, more precisely its proximal phalanx, and to the fifth metacarpal bone. Their function is reflected in the name.

In the article, we tried to most accurately represent the structure of the hand. Anatomy is a fundamental science, requiring, of course, a more thorough study. Therefore, some questions remained unanswered. The structure of the hand and wrist is a topic that is of interest not only to physicians. Knowledge of it is also necessary for athletes, fitness instructors, students and other categories of people. The structure of the hand, as you noticed, is quite complex, and you can study it for quite some time, relying on various sources.

The hand and fingers are the main tools in any work. The decrease in their functionality in many ways leads to a decrease in working capacity, to a limitation of a person's capabilities.

Joints and bones of the hand

The anatomy of the human hand is distinguished by the presence of small bones that articulate with joints of various types. There are three components of the hand: the wrist, metacarpal part, phalanges of the fingers. The wrist in simple terms is called the wrist joint, but from an anatomical point of view, this is the proximal part of the hand. It consists of 8 bones arranged in two rows.

The first proximal row consists of three bones connected by fixed joints. Adjacent to it from the lateral outer side is a pea-shaped bone, inherited by a person from distant ancestors and serving to enhance muscle strength (one of the sesamoid bones). The bone surface of the first row, facing the bones of the forearm, forms a single articular surface for connection with the radius.

Bones of the hand

The second row of bones is represented by four bones distally connected to the metacarpus. The carpal part is shaped like a small boat, where the palmar surface is its concave part. The space between bones is filled with articular cartilage, connective tissue, nerves and blood vessels. Movements in the wrist itself and the movement of its bones relative to each other are almost impossible. But due to the presence of a joint between the carpal part and the radius, a person can rotate the brush, bring it and take it away.

Joints of the hand

The metacarpal part consists of five tubular bones. Their proximal part is connected to the wrist by fixed joints, and the distal part is connected to the proximal phalanges of the fingers by movable joints. The metacarpophalangeal joints are ball-and-socket joints. They allow flexion and extension and rotational movements to be carried out.

The thumb joint is saddle-shaped and provides only extension and flexion. Each finger is represented by three phalanges, connected by means of movable block joints. They perform flexion and extension of the fingers. All joints of the hand have strong joint capsules. Sometimes she capsule can combine 2-3 joints. To strengthen the bone-articular frame, there is a ligamentous apparatus.

Ligaments of the hand

The joints of the human hand are held and protected by a whole complex of ligaments. They have increased elasticity and at the same time strength due to very dense connective tissue fibers. Their function is to ensure movements in the joints no more than the physiological norm, to protect them from injury. In cases of application of increased physical effort (falling, lifting weights), the ligaments of the hand can still be stretched, cases of rupture are very rare.

The ligamentous apparatus of the hand is represented by numerous ligaments: interarticular, dorsal, palmar, collateral. The palmar part of the hand is covered by the flexor retinaculum. It forms a single channel in which the tendons of the flexor muscle of the fingers pass. The palmar ligaments go in different directions, creating a thick fibrous layer, there are fewer dorsal ligaments.

The metacarpophalangeal and interphalangeal joints are strengthened by lateral collateral ligaments, and also have additional ones on the palmar surface. The flexor retinaculum on the palm and the extensor retinaculum on the dorsal side are involved in creating fibrous sheaths for these muscles. Thanks to them and the synovial spaces, the tendons are protected from external influences.

Muscles of the hand

Studying the anatomy of the human hand, one cannot but pay attention to the perfection of the device of its muscular apparatus. All the smallest and most precise movements of the fingers would be impossible without the coordinated work of all the wrist muscles. All of them are located only on the palm, on the back side there is an extensor tendon. By location, the muscles of the hand can be divided into three groups: the muscles of the thumb, middle group and small finger.

Muscles and tendons of the hand

The middle group is represented by interosseous muscles, which connect the bones of the metacarpal part, and vermiform, which are attached to the phalanges. The interosseous muscles bring and spread the fingers, and the worm-like ones bend them in the metacarpophalangeal joints. The muscle group of the thumb makes up the so-called tenar, the elevation of the thumb. They bend it and unbend it, take it away and lead it.

The hypotenar, or elevation of the small finger (little finger), is located on the other side of the palm. The muscle group of the small finger opposes it, abducts and adducts, flexes and unbends. The movements of the hand in the wrist joint are provided by the muscles located on the forearm, due to the attachment of their tendons to the bones of the hand.

Muscles and tendons

Blood supply and innervation of the hand

The bones and joints, muscles and ligaments of the hand are literally permeated with blood vessels. The blood supply is very well developed, which ensures high differentiation of movements and rapid tissue regeneration. Two arteries, the ulnar and radial, come from the forearm to the hand, and, having passed in special channels through the wrist joint, they find themselves between the muscles and bones of the hand. Here, an anastomosis (connection) is formed between them in the form of a deep and superficial arc.

Smaller arteries depart from the arches to the fingers, each finger is supplied with blood by four vessels. These arteries also connect with each other, forming a network. Such a branched type of vessels helps with injuries, when the blood supply to the fingers suffers slightly when any branch is affected.

Arteries of the hand

The ulnar, radial and median nerves, passing through all the elements of the hand, end at the fingertips huge amount receptors. Their function is to provide tactile, temperature and pain sensitivity.

Nerves of the hand

Coordinated and harmonious work of the hand is possible only if the functionality of all its components is preserved. A healthy hand is necessary for a full life of a person, maintaining his ability to work.

Anatomy of the hand

If we consider the hand as a whole, then, as in any other part of the human musculoskeletal system, three main structures can be distinguished in it: the bones of the hand; ligaments of the hand that hold bones and form joints; hand muscles.

Hand bones

The hand has three sections: the wrist, metacarpus and fingers.

wrist bones

The eight small carpal bones are irregularly shaped. They are located in two rows.

The proximal row of carpal bones forms an articular surface convex towards the radius. The distal row is connected to the proximal row with an irregularly shaped joint.

The bones of the wrist lie in different planes and form a groove (carpal groove) on the palmar surface and a bulge on the back. The tendons of the flexor muscles of the fingers run in the groove of the wrist. Its inner edge is limited by the pisiform bone and hook of the hamate bone, which are easily palpable; the outer edge is composed of two bones - the scaphoid and the polygonal.

Metacarpal bones

The metacarpus consists of five tubular metacarpal bones. The metacarpal bone of the first finger is shorter than the others, but differs in its massiveness. The longest is the second metacarpal bone. The following bones decrease in length towards the ulnar edge of the hand. Each metacarpal has a base, body, and head.

The bases of the metacarpal bones articulate with the carpal bones. The bases of the first and fifth metacarpal bones have saddle-shaped articular surfaces, and the rest have flat articular surfaces. The heads of the metacarpal bones have a hemispherical articular surface and articulate with the proximal phalanges of the fingers.

Finger bones

Each finger consists of three phalanges: proximal, middle and distal. The exception is the first finger, which has only two phalanges - proximal and distal. The proximal phalanges are the longest, the distal phalanges are the shortest. Each phalanx has a middle part - a body and two ends - proximal and distal. At the proximal end is the base of the phalanx, and at the distal end is the head of the phalanx. At each end of the phalanx there are articular surfaces for articulation with adjacent bones.

Sesamoid bones of the hand

In addition to these bones, the hand also has sesamoid bones, which are located in the thickness of the tendons between the metacarpal bone of the thumb and its proximal phalanx. There are also inconstant sesamoid bones between the metacarpal bone and the proximal phalanx of the second and fifth fingers. Sesamoid bones are usually located on the palmar surface, but occasionally they are also found on the dorsal surface. The pisiform bone is also referred to as a sesamoid bone. All sesamoid bones, as well as all bone processes, increase the leverage of the muscles that attach to them.

Ligament apparatus of the hand

wrist joint

The radius and bones of the proximal row of the wrist take part in the formation of this joint: the scaphoid, lunate and trihedral. The ulna does not reach the surface of the radiocarpal joint (it is “complemented” by the articular disc). Thus, in the formation of the elbow joint, the ulna plays the largest role of the two bones of the forearm, and in the formation of the radiocarpal joint, the radius.

In the radiocarpal joint, which has an elliptical shape, flexion and extension, adduction and abduction of the hand are possible. Pronation

Antonym - medial edge. .

Movements in the radiocarpal joint are closely related to movements in the midcarpal joint, which is located between the proximal and distal rows of carpal bones. This joint has a complex surface of irregular shape. The total amount of mobility during flexion of the hand reaches 85°, and during extension it is also approximately 85°. Adduction of the hand in these joints is possible by 40°, and abduction by 20°. In addition, a circular motion (circumduction) is possible in the radiocarpal joint.

The radiocarpal and midcarpal joints are reinforced with numerous ligaments. The ligamentous apparatus of the hand is very complex. Ligaments are located on the palmar, dorsal, medial

Antonym - lateral edge. .

Between the bone elevations on the radial and ulnar sides of the palmar surface of the hand, a ligament is thrown - the flexor retainer. It is not directly related to the joints of the hand, but is, in fact, a thickening of the fascia

Carpometacarpal joints of the hand

They are connections of the distal row of carpal bones with the bases of the metacarpal bones. These joints, with the exception of the carpometacarpal joint of the thumb, are flat and inactive. The range of motion in them does not exceed 5-10°. Mobility in these joints, as well as between the bones of the wrist, is sharply limited by well-developed ligaments.

The ligaments located on the palmar surface of the hand make up a strong palmar ligamentous apparatus. It connects the bones of the wrist to each other, as well as to the metacarpal bones. On the hand, ligaments can be distinguished that run arcuately, radially and transversely. The central bone of the ligamentous apparatus is the capitate, to which it is attached more ligaments than to any other bone in the wrist. The dorsal ligaments of the hand are much less developed than the palmar ligaments. They connect the bones of the wrist to each other, making up the thickening of the capsules that cover the joints between these bones. The second row of carpal bones, in addition to the palmar and dorsal ligaments, also has interosseous ligaments.

Due to the fact that the bones of the distal row of the wrist and the four (II-V) bones of the metacarpus are inactive relative to each other and are firmly connected into a single formation that makes up the central bone nucleus of the hand, they are designated as a solid base of the hand.

The carpometacarpal joint of the thumb is formed by the polygonal bone and the base of the first metacarpal bone. The articular surfaces are saddle-shaped. The following movements are possible in the joint: adduction and abduction, opposition (opposition) and reverse movement (reposition

Metacarpophalangeal joints of the hand

Formed by the heads of the metacarpal bones and the bases of the proximal phalanges of the fingers. All these joints have a spherical shape and, accordingly, three mutually perpendicular axes of rotation, around which flexion and extension, adduction and abduction, as well as circular motion (circumduction) occur. Flexion and extension are possible at 90-100°, abduction and adduction - at 45-50°.

The metacarpophalangeal joints are strengthened by collateral ligaments located on the sides of them. On the palmar side, the capsules of these joints have additional ligaments called palmar. Their fibers are intertwined with the fibers of the deep transverse metacarpal ligament, which prevents the heads of the metacarpal bones from moving apart.

Interphalangeal joints of the hand

They have a block-like shape, their axes of rotation pass transversely. Flexion and extension are possible around these axes. Their volume in the proximal interphalangeal joints is 110-120°, while in the distal - 80-90°. All interphalangeal joints are strengthened by well-defined collateral ligaments.

Fibrous and synovial sheaths of the tendons of the fingers

The ligaments of the flexor retinaculum and the extensor retinaculum are of great importance for strengthening the position of the muscle tendons passing under them, especially during flexion and extension of the hand: the tendons rest on the named ligaments from their inner surface, and the ligaments prevent the tendons from moving away from the bones and, with strong muscle contraction, withstand significant pressure .

Gliding of the tendons of the muscles passing from the forearm to the hand and reducing friction are facilitated by special tendon sheaths, which are fibrous or bone-fibrous canals, inside which there are synovial sheaths

The palmar synovial sheaths belong to the tendons of the flexors of the hand and fingers that run in the carpal tunnel. The tendons of the superficial and deep flexors of the fingers lie in a common synovial sheath, which extends to the middle of the palm, reaching the distal phalanx of only the fifth finger, and the tendon of the long flexor of the thumb is in a separate synovial sheath, which passes along with the tendon to the finger. In the area of ​​the palm, the tendons of the muscles that go to the second, third and fourth fingers are deprived of synovial sheaths at some distance and receive them again on the fingers. Only the tendons leading to the fifth finger have a synovial sheath, which is a continuation of the common synovial sheath for the flexor tendons of the fingers.

Muscles of the hand

On the hand, the muscles are located only on the palmar side. Here they form three groups: middle (in the middle section of the palmar surface), a group of muscles of the thumb and a group of muscles of the thumb. A large number of short muscles on the hand is due to the fine differentiation of finger movements.

Middle group of muscles of the hand

Consists of worm-like muscles that start from the tendons of the deep flexor of the fingers and are attached to the base of the proximal phalanges of the second to fifth fingers; palmar and dorsal interosseous muscles, which are located in the interosseous spaces between the metacarpal bones and are attached to the base of the proximal phalanges of the second to fifth fingers. The function of the muscles of the middle group is that they are involved in the flexion of the proximal phalanges of these fingers. In addition, the palmar interosseous muscles bring the fingers of the hand to the middle finger, and the dorsal interosseous muscles spread them apart.

thumb muscle group

Forms the so-called elevation of the thumb on the hand. They start on the nearby bones of the wrist and metacarpus. Among them, there are: a short muscle that removes the thumb, which is attached to its proximal phalanx; a short flexor of the thumb, attached to the external sesamoid bone, located at the base of the proximal phalanx of the thumb; muscle that opposes the thumb, going to the first metacarpal bone; and the adductor thumb muscle, which inserts on the internal sesamoid bone located at the base of the proximal phalanx of the thumb. The function of these muscles is indicated in the name of each muscle.

Small finger muscle group

Forms an elevation on the inside of the palm. This group includes: a short palmar muscle; muscle that removes the little finger; the short flexor of the little finger and the muscle that opposes the little finger. They originate from nearby carpal bones and insert at the base of the proximal phalanx of the fifth toe and fifth metacarpal. Their function is determined by the name of the muscles themselves.

Fingers

Fingers are a unique tool given to us by evolution, allowing us to perform the most complex operations that are inaccessible to any other living creature on earth, helping to communicate and express our emotions.

Try not to use your hands a bit. Complicated? Not difficult, but almost impossible! The main function of the hands, especially small, subtle movements, is provided by the fingers. The absence of such a small organ compared to the size of the entire body even imposes restrictions on the performance of certain types of work. So, the absence of a thumb or part of it may be a contraindication to driving.

Description

Fingers end our limbs. A person has normally 5 fingers on his hand: a separate, opposed to the rest, thumb and index, middle, ring and little fingers arranged in a row.

A person received such a separate arrangement of the thumb in the course of evolution. Scientists believe that it was the opposable finger and the well-developed grasping reflex associated with it that led to a global evolutionary leap. In humans, the thumb is located in a similar way only on the hands (unlike primates). In addition, only a person can connect the thumb with the ring and little fingers and has the ability to both a strong grip and small movements.

Functions

Thanks to the variety of movements in which the fingers of the hand participate, we can:

• pick up and hold objects of various sizes, shapes and weights;
• perform small precise manipulations;
• write;
• gesticulate (the inability to speak led to the intensive development of sign language).

On the skin of the fingertips there are folds, stripes that form a unique pattern. This ability is actively used to identify a person by law enforcement or the security system of employers.

Structure

1. The basis of the fingers is the bone skeleton. The fingers consist of phalanges: the smallest, nail or distal, middle phalanx and proximal phalanx (have all fingers except the thumb). The phalanges of the fingers are small tubular bones - hollow inside. Each phalanx has a head and a base. The middle thinnest part of the bone is called the body of the phalanx. The nail phalanx is the smallest and ends with a distal phalangeal tubercle.
2. The connection of the head and base of adjacent phalangeal bones forms the interphalangeal joints - distal (located farther from the body) and proximal (located closer to the body). The thumb has one interphalangeal joint. Interphalangeal joints are typical axial joints. Movements in them occur in the same plane - flexion and extension.
3. The joints of the fingers are secured by palmar and collateral ligaments that run from the heads of the phalangeal bones to the base of other bones or to the palmar surface of an adjacent bone.
4. The muscular apparatus of the fingers is just a part of the muscles of the hand. The fingers themselves have practically no muscles. The tendons of the muscles of the hand, which are responsible for the mobility of the fingers, are attached to the phalanges of the fingers. The lateral group of muscles of the palmar surface of the hand provides the movements of the thumb - its flexion, abduction, adduction, opposition. The medial group is responsible for the movements of the little finger. The movements of 2-4 fingers are provided by the contraction of the muscles of the middle group. The tendons of the flexor muscles are attached to the proximal phalanges of the fingers. Extension of the fingers is provided by the extensor muscles of the fingers located on the back of the hand. Their long tendons are attached to the distal and middle phalanges of the fingers.
5. The tendons of the muscles of the hand are in a kind of synovial cases, which extend from the hand to the fingers and reach the distal phalanges.
6. The fingers are supplied with blood from the radial and ulnar arteries, which form arterial arches and multiple anastomoses on the hand. The arteries that feed the tissues of the finger are located along the lateral surfaces of the phalanges, along with the nerves. The venous network of the hand originates from the fingertips.
7. The space between the internal structures of the finger is filled with fatty tissue. Outside, the fingers, like most of our body, are covered with skin. On the back surface of the distal phalanges of the fingers in the nail bed is a nail.

Finger injury

When performing various types of work, injury to the fingers is the most common. This is due to the fact that it is with the help of fingers that we do the bulk of the work. Conventionally, finger injuries can be divided into several groups:

• soft tissue injury - cut, bruise, compression,
• injury to a bone or joint - fracture, dislocation, sprain,
• thermal injuries - frostbite, burns,
• traumatic amputations,
• damage to nerves and tendons.

Symptoms depend on the type of injury, but all injuries are characterized by common signs - pain of varying intensity, tissue swelling, hemorrhage or bleeding with an open injury, impaired movement of the injured finger.

Little finger

The smallest, medially located finger. Carries the most minimal functional load. The meaning of the word little finger in Russian is the younger brother, the younger son.

ring finger

It is located between the little finger and the middle finger - it is practically not used independently, which is explained by the commonality of the tendons of the adjacent fingers. Self-load bears when playing on keyboard instruments or printing. There was a belief that a vein went straight to the heart from this finger, which explains the tradition of wearing wedding rings on this finger.

Middle finger

Its name speaks for itself - it is located in the middle of the finger row. More mobile compared to the ring finger, the longest finger of the hand. In sign language middle finger used for offensive movement.

Forefinger

One of the most functional fingers of the hand. This finger is able to move independently of the others. It is with this finger that we point most often.

Thumb

The thickest, free-standing finger. It has only 2 phalanges, it is opposed to the rest, which provides a perfect grasping ability of the hand. The thumb is actively used in gesture communication. The width of the thumb was formerly used as a unit of measurement, equal to 1 centimeter, and the inch was originally defined as the length of the nail phalanx of the thumb.

Question answer

What should be the first aid for a broken finger?

It is possible to suspect a fracture of the finger if, immediately after the injury, severe pain, swelling of the finger, its unnatural position, impaired movement, and a crunch of bone fragments during palpation appear.

First Aid:

• to ensure the immobility of the injured finger with the help of splints made from improvised materials - you can fix the finger with a ruler superimposed on the palmar surface of the finger over the hand and wrist to prevent their movements;
• anesthetize - any painkillers will do;
• apply ice to the injury site;
• in case of damage to the skin, it is necessary to apply a sterile bandage;
• in case of intensive bleeding, if the vessels of the finger are damaged by bone fragments, it is necessary to apply a tourniquet to the base of the finger or to the wrist. With moderate bleeding, a tight bandage is sufficient;
• consult a doctor immediately.

How to get rid of calluses on fingers from a pen?

In people who write a lot by hand during the day, an ugly callus forms on the nail phalanx of the middle finger. You can reduce it by carrying out regular procedures aimed at softening and exfoliating dead skin - use scrubs, moisturizers. To prevent the occurrence of this trouble, you can use special silicone loops that are worn on the finger when writing and prevent roughening and thickening of the skin.

Components of the hand

Without arms, hands, palms, fingers, it would be very difficult for a person. The wrist joint is responsible for the functionality of the hands. Hands should be protected no less than eyes. They are a unique tool created by nature itself, without which one cannot do.

It is the hand that a person puts forward when falling. She suffers first from various fractures and injuries. What you need to know about the structure of the hands in order to be able to save them?

The structure of the human hand

The anatomy of the human hand is considered one of the most complex. Without arteries, veins, nerves and muscles, it is impossible to imagine limbs. Bone hands and her hands are distinguished by the specifics of their density and structure. Ligaments and tendons in the upper and lower extremities form a whole network. Sensory information enters the brain through the hands. He gives signals, and the hand begins to manipulate objects. One has only to give a command to the brain, and the tendons, ligaments of the hand are instantly distracted by it.

The reduction of tendons and ligaments in the human body occurs constantly. The more movements the hand makes, the stronger their contraction will be. If the brushes are inactive, this fact is directly reflected in their condition. The load on the hands occurs constantly, its lion's share falls on the muscles.

The top of the hand is covered with leather. It is she who protects the hand and the entire arm from the aggressive effects of the external environment, which can affect the quality of its functioning. You need to know: the skin tissue of the hand, like any other part of the body, maintains a stable body temperature.

The skin of the hand prevents bacteria from entering the inside of the hands. Poisonous substances can harm the human body. The skin is a natural barrier against various negative components.

Substances that protect the skin of the hands from external influences

The skin layer of the hand is uneven. Pay attention to the condition of the hands on a frosty day: the back of the limb freezes more than the inside. The palm always dries out faster than the back if moisture gets on the organ. This is due to the fact that the number of sweat and sebaceous glands here is less than in the upper part of the arm. On the arm are blood and lymphatic vessels, nerves.

What substances make the skin of the hand elastic, preventing it from bursting from constant stress? These substances are:

These substances belong to the category of proteins. But they are quite vulnerable to ultraviolet light that can penetrate into upper layer skin. If a person's hands become unaesthetic, wrinkled, lose their elasticity, then all this is a consequence of exposure to ultraviolet radiation, which destroys proteins. This mechanism does not start immediately.

In the skin of the hand, as in any other part of the skin of the body, melanin is formed. The fact that human skin is able to absorb the effects of ultraviolet rays is his merit. However, if the human body is exposed to long-term exposure to ultraviolet rays, age spots begin to form on the hand.

Bones that form the hand

The anatomy of the human hand has been the subject of medical study for thousands of years. About what elements the limbs consist of, what is the carpal joint, Hippocrates wrote, the discoveries of which have not lost their value even today. Renaissance artists also played an equally significant role in the study of the structure of the hand. Quite reliably they gave an idea of ​​\u200b\u200bit in their writings. eminent figures era of the Enlightenment.

Major bones and joints of the hand

Today, the hand is the subject of consideration not only in medicine. It is studied by representatives of scientific industries related to robotics and nanotechnology. It was the hand that became the prototype of modern manipulators, the source of ideas for a number of engineering technologies aimed at maximizing the automation of production operations.

If you count the bones of the fingers and wrist, you get the number 27. What holds the bones of the hand and muscles together? Tendons, the disruption of which is no less dangerous than the joints. 8 bones are the basis of the skeleton of the hand. They are not disparate, autonomously operating structures - they are grouped. It is these 8 bones of the hand that form the part of the body, which is commonly called the wrist. The carpal bones look very unusual: they form two rows. The first consists of the scaphoid or lunate bone. There are two more types of bones in the carpus: trihedral and pisiform. The second row of bones in the carpal are the trapezium, capitate, and hamate bones. It is customary to distinguish 3 parts of the arm bone: its base, head and body.

Next is the pastern of the brush. Sometimes it is called "finger bones", but this is not true. After the metacarpal bones, only the bones of the fingers are located, and they are already a completely different part of the limb. There are 14 such bones, they form the phalanges of the fingers. Fingers, from index to little finger, have 3 phalanges. The exception is the thumb: the bones of the thumbs of the hand consist of two phalanges.

Muscles, vessels and the relationship between parts of the hand

The structure of the hand: muscles and tendons

Muscles play a special role in the functioning of the hand. They are located at the wrist and below. The movement of the fingers of the hand, like her own, is impossible without the participation of muscles that perform different roles. The muscles that affect the state of the hand and its wrist are anterior, posterior or internal. Carpal placed anterior and posterior. The former are responsible for bending the hand, without the latter it is impossible to extend it. Its internal muscles carry out the movements of the fingers. Brushes perform a number of vital functions for humans. They provide precise coordinated hand movements.

There is an erroneous opinion: most of the human sensory cells are located in the carpus. No, this category of cells is located on another part of the hand - on the fingertips. It is she who makes it possible to know the world through touch. The carpal tissue is not as sensitive as the fingertips. Nails protect such a vulnerable part of the hand. The nail is a horny plate, whose basis is keratin. If the amount of keratin in the nails decreases, this increases the pain vulnerability of the lower part of the hand. This substance is also in the skin, but in the nail it has other properties. The more keratin in the nails, the stronger they are.

The blood supply to the joints is carried out from the deep palmar arterial arch, palmar and dorsal arterial network. Its quality directly affects not only the articular tissue, but also the condition of the hand. A good blood supply to the hand allows it to function actively.

All parts of the hand are closely interconnected with each other: a violation of the functioning of tissues in one part of it will immediately affect another.

Hand joints

The hand has joints, which are usually classified according to their location. The joint is no less important part in the functioning of the hand than the ligaments, muscles, skin, bones. The wrist joint is considered the most complex in its structure. It resembles an ellipse, which is strengthened by various types of ligaments.

The internal structure of the fingers

This joint is involved in flexion and extension. Such a wrist joint has one feature: it is able to combine different types of movements. The mid-carpal joint is a junction of the proximal and distal rows of bones. It is attached by ligaments of the hand and has a separate articular capsule. The intercarpal joints in this area form a separate group of tissues. Each such joint connects the bones of the wrist. This ensures the normal functioning of the hand, which involves various movements: grasping, throwing, etc.

The pisiform joint is located in the tendon. Together with the trihedral bone of the hand, it forms a single whole. The thumb has another joint, which is saddle-shaped. This is the carpometacarpal joint. It is able to move around two axes and is responsible for grasping movements: through it, people can control their hand when taking an object. It is believed that this carpometacarpal joint is the main feature of the human hand, which distinguishes it from the paws of mammals. It will not be difficult to find such a carpal joint on the arm. It is flat in shape. It is located between the second row of carpal bones and 2-4th row of metacarpal bones.

The metacarpal joint belongs to another group of articular tissues. Between the bases of the 2-5 metacarpal bones is such a joint. In its functioning and location, the metacarpophalangeal joint will differ significantly. If the joint is located on the 2-5th finger of the hand, its shape will be spherical. It is in this area, where the interphalangeal joints of the hand are located, that the tendons and the median nerve are located. This is another separate group. The carpal joint related to it is located between the head and the base of the middle phalanx. It is between the head of the middle and the base of the final phalanges. Such a carpal joint is capable of losing its shape and deforming during operation.

People's hands are often injured. To strengthen bones, ligaments and joints, doctors recommend drugs that help restore and renew tissues, as well as health-improving physical exercises.

Wrist

One of the most functional elements of the human body is the hand. It is this device that exalts Homo sapiens over many mammals. It is quite difficult to imagine a full life without healthy arms and hands. Even the simplest daily hand movements (brushing teeth, fastening buttons, combing) will be impossible if the upper limb is injured. The structure of the hand has a number of features, let's try to understand the main ones.

Structural features of the human hand

The human hand has a specific and complex structure. The anatomy of the hand is a complex complex mechanism, consisting of various elements:

• The bone skeleton (carpal skeleton) provides the hardness and strength of the entire limb.
• Tendons and ligaments connect the bone base and muscles, provide elasticity and flexibility to the limb, and also participate in the formation of joints.
• Vessels provide nutrition to the tissues of the hand and provide them with oxygen.
• Nerve fibers are responsible for the sensitivity of the skin of the limb, contraction and relaxation of muscles, and provide a reflex response to an external stimulus.
• The skin covers perform a protective function, delimiting the structures of the hand from environmental factors, regulate the internal temperature.

Each component of the human hand performs its own functions, but together they provide a variety of brush manipulations, from the simplest to the most complex. The figure below shows the main elements of the upper limb.

Elements of the hand

Skin properties

The skin covers the entire body, somewhere it is softer, somewhere rougher. What determines the nature of the skin? Everyone knows that the palm has thicker skin than the back surface. This is due to the fact that it is the palmar surface of the hand that is most often subjected to friction, chemical and mechanical stress. Thus, the protection of muscles, blood vessels and nerve fibers by the skin from environmental influences is realized.

The back surface has more sebaceous and sweat glands than the palmar. The elasticity of the skin of the hands and its elasticity depend on the amount of collagen and elastin in it, which are specific proteins. These substances are destroyed by ultraviolet radiation. With a decrease in the content of collagen and elastic fibers in the thickness of the skin of the hands, dryness, wrinkling, and cracking are observed. These signs are more common in older women, but there are exceptions. One of the earliest symptoms of excessive exposure to ultraviolet radiation on the skin is the appearance of age spots.

Bone apparatus

How many bones are in a person's hand? This question has been asked at least once by each of us. The hand is made up of 27 small bones. So, the human hand consists of several departments:

• The wrist is a structure consisting of 8 grouped bones connected by a ligamentous apparatus. The wrist includes such bones as: scaphoid, trapezium, pisiform, trihedral, trapezoid, hamate, capitate, lunate.
• The metacarpus is a row consisting of five oblong bones. This section of the hand is located between the wrist and fingers.
• Fingers of the hand - four fingers of 3 phalanges and a large one of two phalanges.

The bones of the hand are rather small, however, it is their small size that increases the flexibility and stability of the hand frame when physical impact to the skeleton. The bones of the hand are most often subjected to significant stress. After all, each of us at least once in our lives noticed that when falling, reflexively, the upper limbs move forward. The structure of a human limb can be found in the photo below.

Muscular apparatus

Undoubtedly, brush movements would not be possible without the participation of muscles. The skeletal muscles of the hand and fingers provide clarity and coordination of movements in them. The muscular apparatus of the arm consists of many individual muscles located in layers on both sides. Some of them are responsible for flexion of the palm, others for its extension. The muscles of the hand are attached to the bones through tendons and ligaments. Damage to any of the listed components of the hand makes it impossible to perform its basic functions. The muscles of the hand pass into tendons, which are attached to the bone base. Thus, due to the well-coordinated work of the nervous, vascular and ligamentous-muscular systems, the entire skeleton moves.

Muscular apparatus of the right hand

Joints and ligaments

The most complex and important wrist joint is the wrist joint. The wrist joint is formed by the ulna, the wrist bone of the elbow and the wrist. The bones of the elbow form a complex elliptical joint with the wrist. Its value is quite large, since it is one of the few articular joints that provide combined movements of the arm (rotation, flexion and extension). The wrist joint is considered the key joint of the upper limb. However, the role of all other joints of the hand should not be underestimated, since only together they form a full-fledged skeleton of the hand. Well-coordinated work of the wrist and other joints ensures its normal and full functioning. Due to normal mobility in the joints, the muscles of the hand can fully contract and relax, setting the skeleton in motion. The following figure gives an idea of ​​how the wrist and other joints of the upper limb are located.

Joints and ligaments

Innervation or nervous system

Many are mistaken, believing that the back of the hand is the most equipped with nerve endings. In fact, most of them are at your fingertips. It is the abundance of nerve endings at the fingertips that provides tactile and sensory sensitivity. In people with visual impairments (especially congenital ones), the ability to perceive the world through touch with the fingertips is especially developed. Such sensitive areas protect the nails. The nail plates are made up of keratin. If the amount of keratin in the nails decreases, they become brittle and thin.

Blood supply to the hands

The nutrition of all structures of the human hand is provided by the radial and ulnar arteries, which form deep and superficial arcs of blood supply. The abundance of vessels and a complex network of anastomoses provide the most efficient operation of the limb.

Blood supply to the hand

What is the difference between a human hand and a monkey hand?

We all remember from the school curriculum one of the most famous theories of the origin of man from primates. Indeed, the human body (including the skeleton) has certain similarities with the body of primates. The same applies to the structure of the brush. However, if this hypothesis is consistent, the human hand has changed significantly in the process of evolution. Evolutionary "engine" of such development is labor. Thus, the human upper limb has a number of structural features:

• saddle shape of the 1st carpometacarpal joint;
• the groove for the tendons of the hand, nerve fibers and blood vessels in the wrist area deepened;
• the bones of the 1st finger became wider in comparison with the others;
• the length of the phalanges from the 2nd to the 5th fingers is shorter than in the monkey;
• the palmar bones of the hand, having a connection with the 1st finger, have shifted towards the palm.

The structure of the human hand has a number of features that provide precise and coordinated movements.

Human anatomy is an extremely important area of ​​science. Without knowledge of features human body it is impossible to develop effective methods for diagnosing, treating and preventing diseases of a particular area of ​​the body.

The structure of the hand is a complex and complex section of anatomy. The human hand is characterized by a special structure that has no analogues in the animal world.

To streamline knowledge about the structural features of the upper limb, it should be divided into sections and consider the elements, starting with the skeleton, which bears the rest of the tissues of the hand.

Departments of the hand

The layered structure of tissues, starting from the bones and ending with the skin, should be disassembled according to the sections of the upper limb. This order allows you to understand not only the structure, but also the functional role of the hand.

Anatomists divide the hand into the following sections:

1. The shoulder girdle is the area where the arm is attached to the chest. Thanks to this part, the underlying sections of the arm are tightly fixed to the human body.
2. Shoulder - this part occupies the area between the shoulder and elbow joints. The basis of the department is the humerus, covered with large muscle bundles.
3. Forearm - from the elbow to the wrist joints is a part called the forearm. It consists of the ulna and radius bones and many muscles that control the movements of the hand.
4. The hand is the smallest but most complex part of the upper limb. The hand is divided into several sections: the wrist, metacarpus and phalanges of the fingers. We will analyze the structure of the brush in each of its departments in more detail.

It is not in vain that human hands have such a complex structure. A large number of joints and muscles in different areas of the body allow you to make the most precise movements.

Bones

The basis of any anatomical region of the body is the skeleton. Bones perform many functions, ranging from supporting and ending with the production of blood cells within the bone marrow.

The girdle of the upper limb keeps the arm on the torso thanks to two structures: the collarbone and the shoulder blade. The first is located above the upper chest, the second covers the upper ribs from behind. The shoulder blade forms an articulation with the humerus - a joint with a large range of motion.

The next section of the arm is the shoulder, which is based on the humerus - a fairly large element of the skeleton that holds the weight of the underlying bones and integumentary tissues.

The forearm is an important anatomical part of the hand, small muscles pass through here, providing the mobility of the hand, as well as vascular and nerve formations. All these structures cover two bones - the ulna and the radius. They are articulated with each other by a special connective tissue membrane, in which there are holes.

Finally, the most complex section of the upper limb in terms of its structure is the human hand. The bones of the hand should be divided into three sections:

1. The wrist consists of eight bones lying in two rows. These bones of the hand are involved in the formation of the wrist joint.
2. The skeleton of the hand is continued by the metacarpal bones - five short tubular bones that run from the wrist to the phalanges of the fingers. The anatomy of the hand is designed in such a way that these bones practically do not move, creating support for the fingers.
3. The bones of the fingers are called phalanges. All fingers, with the exception of the thumb, have three phalanges - the proximal (main), middle and distal (nail). The human hand is designed so that the thumb consists of only two phalanges, without having a middle one.

The structure of the hand has a complex structure not only of the skeleton, but also of the integumentary tissues. They will be mentioned below.

Many are interested in the exact number of bones on the upper limb - on its free part (with the exception of the shoulder girdle), the number of bones reaches 30. This big number due to the presence of numerous small joints of the hand.

joints

The next step in studying the anatomy of the human hand is to analyze the main joints. There are 3 large joints on the upper limb - shoulder, elbow and wrist. However, the hand has a large number of small joints. Large articulations of the hand:

1. The shoulder joint is formed by the articulation of the head of the humerus and the articular surface on the shoulder blade. The shape is spherical - this allows you to make movements in a large volume. Since the articular surface of the scapula is small, its area increases due to cartilaginous formation - the articular lip. It further increases the range of motion and makes them smooth.
2. The elbow joint is special because it is formed by 3 bones at once. In the elbow area, the humerus, radius and ulna bones are connected. The shape of the block joint makes only flexion and extension possible in the joint, a small amount of movement is possible in the frontal plane - adduction and abduction.
3. The wrist joint is formed by the articular surface at the distal end of the radius and the first row of carpal bones. Movement is possible in all three planes.

The joints of the hand are numerous and small. They just need to be listed:

• Mid-carpal joint - connects the upper and lower rows of the bones of the wrist.
• Carpometacarpal joints.
• Metacarpophalangeal joints - hold the main phalanges of the fingers on the fixed part of the hand.
• There are 2 interphalangeal joints on each finger. The thumb has only one interphalangeal joint.

The interphalangeal joints and metacarpophalangeal joints have the largest range of motion. The rest only supplement the general amplitude of mobility in the hand with their small movement.

Bundles

It is impossible to imagine the structure of a limb without ligaments and tendons. These elements of the musculoskeletal system consist of connective tissue. Their task is to fix individual elements of the skeleton and limit the excessive range of motion in the joint.

A large number of connective tissue structures are present in the region of the shoulder girdle and the connection of the scapula with the humerus. Here are the following links:

• Acromioclavicular.
• Coraco-clavicular.
• Coraco-acromial.
• Upper, middle and lower glenohumeral ligaments.

The latter strengthen the articular capsule of the shoulder joint, which experiences enormous loads from a large range of motion.

There are also connective tissue elements in the area of ​​the elbow joint. They are called collateral ligaments. There are 4 in total:

• Front.
• back.
• Beam.
• Elbow.

Each of them holds the articulation elements in the respective departments.

The ligaments of the wrist joint have a complex anatomical structure. The joint is kept from excessive movements by the following elements:

• Lateral radial and ulnar ligaments.
• Dorsal and palmar wrist.
• Intercarpal ligaments.

Each has several tendon bundles that envelop the joint from all sides.

The carpal tunnel, which contains important vessels and nerves, is covered by the flexor retinaculum, a special ligament that plays an important clinical role. The bones of the hand are also strengthened by a large number of connecting bundles: interosseous, collateral, dorsal and palmar ligaments of the hand.

muscles

Mobility in the whole arm, the ability to perform huge physical activity and precise small movements would not be possible without the muscular structures of the hand.

Their number is so large that listing all the muscles does not make much sense. Their names should be known only to anatomists and doctors.

The muscles of the shoulder girdle are not only responsible for movement in the shoulder joint, they also provide additional support for the entire free part of the arm.

The muscles of the hand are completely different in anatomical structure and function. However, flexors and extensors are distinguished on the free part of the limb. The former lie on the front surface of the arm, the latter cover the bones behind.

This applies to both the shoulder and forearm areas. The last section has more than 20 muscle bundles that are responsible for the movements of the hand.

The brush is also covered with muscle elements. They are divided into thenar, hypothenar and middle muscle groups.

Vessels and nerves

The work and life of all the listed elements of the upper limb is impossible without a full blood supply and innervation.

All limb structures receive blood from the subclavian artery. This vessel is a branch of the aortic arch. The subclavian artery passes with its trunk into the axillary, and then into the brachial. A large vessel departs from this formation - the deep artery of the shoulder.

The listed branches are connected into a special network at the level of the elbow, and then continue into the radial and ulnar branches, going along the corresponding bones. These branches form arterial arches, from these special formations small vessels extend to the fingers.

The venous vessels of the extremities have a similar structure. However, they are supplemented by subcutaneous vessels on the inner and outer parts of the limb. The veins flow into the subclavian, which is a tributary of the upper vena cava.

The upper limb has a complex innervation pattern. All peripheral nerve trunks originate in the region of the brachial plexus. These include:

• Axillary.
• Muscular skin.
• Ray.
• Median.
• Elbow.

Functional role

Speaking about the anatomy of the hand, it is impossible not to mention the functional and clinical role of the features of its structure.

The first lies in the features of the function performed by the limb. Due to the complex structure of the hand, the following is achieved:

1. Strong Belt upper limbs holds the free part of the arm and allows you to perform huge loads.
2. The moving part of the arm has complex but important articulations. Large joints have a large range of motion that is important for the operation of the hand.
3. Fine articulations and the work of the muscle structures of the hand and forearm are necessary for the formation of precise movements. It is necessary for the performance of daily and professional activities of a person.
4. The supporting function of immobile structures is complemented by muscle movements, the number of which is especially large on the arm.
5. Large vessels and nerve bundles provide blood supply and innervation to these complex structures.

The functional role of the anatomy of the hand is important to know for both the doctor and the patient.

Clinical Role

In order to properly treat diseases, understand the features of the symptoms and diagnosis of diseases of the upper limb, you need to know the anatomy of the hand. Structural features have a significant clinical role:

1. A large number of small bones leads to a high frequency of their fractures.
2. Movable joints have their own vulnerabilities, which is associated with a large number of dislocations and arthrosis of the joints of the hand.
3. Abundant blood supply to the hand and a large number of joints leads to the development of autoimmune processes in this area. Among them, arthritis of the small joints of the hand is relevant.
4. Ligaments of the wrist, tightly covering the neurovascular bundles, can compress these formations. There are tunnel syndromes that require consultation of a neurologist and a surgeon.

A large number of small branches of nerve trunks is associated with the phenomena of polyneuropathy in various intoxications and autoimmune processes.
Knowing the anatomy of the upper limb, one can assume the features of the clinic, diagnosis and principles of treatment of any disease.

Dislocation of the thumb is a common injury in a child.

Sprained fingers can happen to anyone. This small injury can cause great difficulties in your life. What to do in such a situation, how to help yourself or your child? The best remedy for injury prevention is information about why and how injury occurs and what can be done to avoid it.

• What it is?
• Causes
• Diagnosis and treatment
• Rehabilitation after dislocation
• Finger injuries in children

A dislocation of any finger of the hand is a small but very unpleasant problem. Such injuries are always very painful, because the hands have the most nerve endings, and the bones and ligaments in this area are very fragile and delicate. It also causes many additional inconveniences, for example, dislocation of the thumb for a long time can deprive a person of working capacity.

Fingers are a very important part of our body, it is with their help that we perform all the necessary actions for servicing ourselves, eating, performing any type of activity.

What it is?

A dislocation is a displacement of the articular surfaces of the bones and a rupture of the articular capsule, when the articular part of the bone comes out of the articular capsule, and the joint capsule and ligaments that hold the bones and muscles are damaged. Upon receipt of this injury, the shape of the joint changes and pain appears during movement.

If the articular surfaces are not completely displaced, then this type of dislocation is called incomplete.

Dislocation of the thumb

Of all types of finger injuries, the most common is a dislocation or displacement of the thumb. This is due to its anatomical features. It usually occurs at the metacarpophalangeal joint. In this case, the thumb can be turned to the back of the hand, to the palm, to the outside of the hand.

Such injuries most often occur with a sharp hyperextension of the thumb, for example, when falling on an outstretched hand. Then the weight of the body falls on the proximal phalanx of the thumb and the bones are shifted to the back of the hand, while the metacarpal head pops out of the articular bag.

Causes

Any dislocation occurs due to the effect on the joint of a force that exceeds the ability of the ligaments and muscles to hold the bone components in the desired position.

Dislocation of the middle finger often occurs as a result of a sharp blow to the fingers of the hand, while a combination of injuries to several fingers at once is possible - the ring finger and the little finger.

Dislocation of the little finger on the hand is also a fairly common injury. The muscles and ligaments in this joint are much weaker. With an unsuccessful fall, awkward hand movement, even with an excessively strong handshake, a closed injury to the little finger is possible.

Symptoms

With a dislocation of the fingers, the symptoms occur immediately after the injury and cause significant inconvenience to the patient. Signs may be as follows:

1. very severe pain that appears immediately at the time of injury;
2. visible deformity of the joint;
3. inability to move a finger - bend it or straighten it;
4. the joint swells sharply and increases in size;
5. at the site of the injury, the skin turns red, and the injured finger, on the contrary, turns pale;
6. possible damage to the skin and visible ruptures of ligaments and muscles.

Diagnosis and treatment

Diagnosis of dislocation of the joint of the fingers does not cause any difficulties. This diagnosis is made after examining the damage to the hand and an X-ray image, which allows you to thin the site of injury and exclude a fracture and hemorrhage into the articular cavity.

First aid should be as follows:

• the injured hand must be removed from all constraining objects - gloves, rings, and so on,
• apply cold - to reduce swelling and pain relief,
• the finger must be fixed with a bandage to avoid further injury;
• go to the emergency room.

What to do if a finger is dislocated, if it is impossible to provide first aid due to lack of conditions, for example, while walking or relaxing? In this case, you need to try to fix the finger with a handkerchief, any means at hand, to reduce swelling, keep your finger up and try not to touch the sore hand when moving.

When contacting a doctor, treatment tactics will depend on the severity, time elapsed since the injury, and the condition of the joint capsule and ligaments. If the finger is dislocated, treatment will focus on pushing the joint back into place and fixing it.

The doctor's tactics are usually as follows:

• anesthesia of the injured limb;
• reduction;
• plaster cast for 2-3 weeks.

In case of severe injuries, rupture of the ligamentous apparatus, bone damage, surgical treatment may be required.

If you sprained your finger - what to do to set it yourself? It is categorically not recommended to set anything on your own, this can lead to additional injuries, and after that treatment will only be possible surgically.

If it is not possible to get medical help in the near future and with simple types of dislocation, for self-reduction of the dislocation, you need to carefully pull the injured finger along the rest until the joint falls into place. This is accompanied by a characteristic click and without anesthesia - an extremely painful procedure. If you look at the photo of a dislocation of the finger, it will help to get a general idea about the anatomical structure of the joint and methods of reducing dislocations on your own.

Rehabilitation after dislocation

If you have a dislocation of the phalanx of the finger or a more complex injury, rehabilitation begins after the removal of the plaster cast. To strengthen the articular apparatus, muscles and joint development, it is necessary to engage in physiotherapy exercises daily.

Finger injuries in children

Weak ligaments, thin fingers and increased physical activity lead to the frequent occurrence of this type of injury in children. Dislocation of the child's fingers due to severe pain causes panic in the victim and his parents. The most important thing is to calm the child, fix the injured limb as soon as possible, apply cold and take the child to the hospital.

It is absolutely undesirable to set a dislocation in a child on your own, so as not to lead to serious complications. You can calm the child, first of all, by calming down the parents themselves. If the baby does not see the frightened faces of those around him, it will be easier for him to endure pain, and he will understand that nothing terrible has happened.

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Fractured little finger

Fractures of the upper extremities, including the phalanges of the fingers, are fairly common injuries for both adults and children of various ages. Usually such damages are easily diagnosed and do not cause big difficulties in treatment. However, in order for such injuries not to have negative consequences and complications, it is very important to contact a specialist in time, undergo the necessary diagnostics and therapy. In no case should you self-treat fractures, since in this case there is a high probability of improper fusion of the bones, which can lead to immobilization of the finger and loss of functionality.

Fracture of the little finger on the hand is a fairly common occurrence. The reason for this is the peculiarities of the location of this finger on the hand. Being extreme, he suffers most from falls, bumps, and also when working with a variety of mechanisms.

In this case, the nail phalanx most often suffers, soft tissues and the nail plate can be damaged. Regardless of the quality of the treatment, such damage may be irreparable, preserving the deformation of the nail or skin of the finger.

Causes of damage to the little finger on the hand

The causes of this type of damage can be different. The most common is a fall on the hand. Also, an injury can occur due to a heavy object hitting the little finger, strong pressure on the phalanx, or when the finger enters the mechanism, the action of which is twisting or pressure.

In any case, it must be diagnosed in time and treated immediately.

It is important to take into account the fact that not only the phalanges of the little finger, but also the joints can suffer. Such injuries are quite difficult to recognize, since they may not give visible symptoms. In this case, you should pay attention to the functionality of the finger, the presence of discomfort or pain. If, after trauma, any of the signs indicate the possible presence of a fracture, it is necessary to undergo a diagnosis.

The main symptoms of a fracture

The symptoms of a fracture of the little finger are usually quite obvious and allow you to quickly determine the presence of an injury of this type. Symptoms that the victim himself can easily identify visually are as follows:

• swelling of the injured finger;
• sharp pain, aggravated by flexion and extension of the phalanx, as well as with a load on the finger;
• the appearance of a hematoma - blue or redness of the finger;
• the inability to normally carry out the usual manipulations of the injured finger.

If we are talking about a fracture with a displacement, then the deformation of the phalanx, the presence of protrusions at the places of displacement of the bones, will be obvious. Open fractures are characterized by the presence of ruptures of the skin and soft tissues, the exit of fragments to the outside.

There are symptoms that the victim himself is unlikely to be able to notice. Their presence is determined by a specialist. These include:

• curvature or shortening of the finger caused by displacement of the phalanx bone;
• the presence of severe pain when stretching the little finger;
• noticeable mobility of fragments, their crunch when pressed.

In the case of an intra-articular fracture of the little finger, it will be somewhat more difficult to determine it. The only symptom that clearly indicates the presence of such an injury will be the immobilization of the finger, the inability to perform the usual manipulations. An accurate diagnosis in this case can only be made after examination and radiography.

Regardless of whether the victim managed to independently determine the presence of a fracture of the little finger or not, he must definitely contact a specialist for further diagnosis and treatment. A competent approach will guarantee the return of all functions of the damaged finger to normal.

Finger Fracture Diagnosis

The main methods for diagnosing a fracture of the little finger are a visual examination by a doctor and x-rays. In the first case, the specialist examines the finger, determines the presence of pain during palpation and the load on the phalanx. Also, the doctor must necessarily collect a detailed history - how and when the damage was done.

If the diagnosis of a fracture of the little finger in a child is carried out, then there is a high probability of difficulties in determining the localization of the damage. This is due to the presence of uncovered growth zones. In this case, the fracture will not be noticeable on x-ray. To determine its presence is possible only with a detailed examination of the injured area, comparing healthy fingers with the victim.

Little finger fracture treatment

Usually, therapy for a fracture of the little finger on the arm is limited to conservative treatment. It includes anesthesia of the finger, its immobilization. To immobilize the phalanx, a plaster or splint is used.

In the case of an open fracture with damage to soft tissues and skin, surgical intervention. After fixation of the fracture, a course of physiotherapy is carried out, which contributes to the speedy fusion of the bone and helps to quickly restore the functionality of the phalanx.

The bandage must be correctly applied. The position of the finger should be half-bent. For maximum fixation, a plaster splint or splint is applied from the nail phalanx to the base of the hand. The duration of wearing such a cast depends on how long the little finger will heal. On average, this period is 3-4 weeks. Fracture received in childhood heals faster. Wearing a cast usually comes down to a couple of weeks.

In no case should you try to fix the finger yourself at home. This leads to the fact that after fractures the phalanges grow together incorrectly, the finger is immobilized and has deformities. Such a procedure must be carried out by a specialist in a medical institution and only after diagnosis.

Recovery after a fracture

In order to restore all the functions of the damaged little finger after an injury, it is imperative to undergo a rehabilitation course after a fracture, which includes special therapeutic exercises. They are aimed at developing the finger, getting rid of the appeared bone calluses, puffiness, etc.

If, after removing the cast, the finger continues to bother (there are pain, severe bruising), you should contact a specialist and consult. It is possible that they are the result of prolonged immobilization of the finger. However, there may be situations when such signs indicate improper bone fusion. In this case, you can not do without repeated x-rays, which will show the true cause of the symptoms.

Fingers are the most important tools in human life. They help to cope with everyday activities, engage in art, sports, and work activities. Therefore, it is so important to monitor their health and normal functioning. And at the first signs of damage, both fractures and injuries, or severe bruises, it is very important to contact specialists in a timely manner and carry out treatment.