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median h '

intrinsic muscles of the hand -

ulnar h .

radial h .

:/÷ ÷ ÷: ÷ ÷ :÷
brevis and dermis medial
Palmares palmar aponeurosis of Skin on the superficial b .
of improves grip
flexor retinaculum margin of the hand ulnar h . ( CS , It )

Dorsal interossei Adjacent sides of metacarpals Extensor hood & base of proximal Deep b -

of ulnar n .
Abduction of It,
^

/
( 4 muscles ) phalanges of IF ,
MF ,
RF ( CS ,
I MF ,
RF @ mcpj
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Palmar inlewssei sides of metacarpals Extensor hoods of thumb IF ,

RF Deep b -

of ulnar n '

Adduction of thumb
.
, ,

/
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, IF , RF , LF @ mcpj

Adductor pollicis Transverse head -

metacarpal 111 Base of proximal phalanx & Deep br .

of u l n a r n . Adducts thumb

oblique head -

capitate & extensor hood of thumb C c S . 7

bases of metacarpals 114111

hoods It MF
deep br of
RF LF
.

Lumbricalis FDP tendons Extensor of medial 2x Flex while

mcpjs
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, ,
ulnar
,
n .

digital
extending ipjs
br of
I 4 muscles ) Lateral 2x
-

median h .

:÷÷÷÷÷÷:÷ :÷÷÷÷÷÷: :
Flexor pollicis Tubercle of trapezium & proximal phalanx of the thumb V
Flexes thumb at

brevis flexor retinaculum mcpj

.

HYPOTHENARMUSC .

nnnnrrrrrrrrrrr

opponents dig Iti Hook of hamate & flexor Medial aspect of metacarpal V
Deep br .
of Laterally rotates

mini mi retinaculum ulnar h .

I CS .
) metacarpal V

/
.

Abductor digits Pls i for m , the pl S o h a m a te proximal phalanx of LF Abduct LF @

mcpj
minami Fcu
ligament , tendon of
game

V
Flexor digit Hook of hamate & proximal phalanx of LF Flexes LF at

mini mi brevis flexor re t i n a c u l u m

mcpj
.
FRACTURE
#
MANAGEMENT -

MUST MEMORISE

* Bone healing
STAGE 1 : INFLAMMATION @ I -

7 days post # -

inflammatory process that star ts rapidly & lasts until fibrous tissue ,
cartilage ,
or bone formation
begins
• bone necrosis seen at ends of # fragments

o
typical inflammatory response due to release of powerful cytokines from injury to soft tissues & degranulation of platelets

c.
fracture hematoma
gradually replaced by granulation tissue

o
osteoclasts remove necrotic bone @ fragment ends

STAGE 2 : SOFT CALLUS FORMATION @ 2 -

3152 post
-

o characterised by callus growth

o
pain & swelling would 've decreased by this time

o
fragments a re no
longer moving freely

°
At the end of SC formation , stability is adequate to prevent shortening but angulation at the
fracture site may

still occur

STAGE 3 :
HARD CALLUS FORMATION C 3- 4152 post #
-

°
Fracture ends linked together by soft callus

endo Chon drat converted to rigid calcified tissue ( woven bone )

.
soft callus undergoes ossification and callus is

•
Bone callus growth begins at
periphery of fracture site , where t h e strain is the lowest

STAGE 4 : REMODELLING @ fe w months to several years post #

-

Canal
Begins once fracture has solidly united with woven bone and until bone becomes like was
lasts it medullary A
o
what , incl .

°
woven bone gets slowly replaced by lamellar bone through surface erosion & osteoma ) remodelling

* Types of hand & wrist fractures

1 DR # 2 Thumb fractures some dislocation or

.
.

→ Bennett # :
base of MC bone , accompanied by Subluxation
.

-
outward -

FOOSH ;
dorsal displacement
3. Metacarpal fractures

-
inward majority are stable , simple , & closed .

}
5. proximal phalanx fracture
intra -

articular # with

muscles & teh

dislocation of radio carpal j't . can be
complex due to pull of multiple dong
extended pronated
fall on , → rotational & angular deformity
wrist with T carpal compression
often unstable due to forces exerted on fracture by intrinsic & ex
↳ m o re c o m m o n
force on dorsal rim .

4 .

also , scaphoid fracture -

complex , insufficient blood SS .

↳ risk of nonunion / main h i m 6 . Middle phalanx #

non displaced stable fractures w/o

angulation buddy tap g '
-

displaced 1 angular -

closed reduction .

avulsion

7. distal phalanx # ( Mallet 1 volar plate FDP tendon )

injury
-