WRIST AND HAND

Surgical Anatomy--FRACTURE OF LOWER END OF RADIUS: _Colles' fracture_;
_Chauffeur's fracture_; _Smith's fracture_; _Longitudinal
fracture_; _Separation of epiphysis_--FRACTURE OF LOWER END OF
ULNA: _Shaft_; _Styloid process_; _Separation of
epiphysis_--FRACTURE OF CARPAL BONES--DISLOCATION: _Inferior
radio-ulnar joint_; _Radio-carpal joint_; _Carpal bones_;
_Carpo-metacarpal joint_--SPRAINS--INJURIES OF FINGERS:
_Fractures_; _Dislocations_; _Mallet finger_.

INJURIES IN THE REGION OF THE WRIST

These include fractures of the lower ends of the bones of the forearm
and separation of their epiphyses; sprains and dislocations of the
inferior radio-ulnar, and of the radio-carpal articulations; and
fractures and dislocations of the carpus.

#Surgical Anatomy.#--The most important landmarks in the region of the
wrist are the styloid processes of the radius and ulna. The tip of the
radial styloid is palpable in the "anatomical snuff-box" between the
tendons of the long and short extensors of the thumb, and it lies
about half an inch lower than the ulnar styloid. The ulnar styloid is
best recognised on making deep pressure a little below and in front of
the head of the ulna, which forms the rounded subcutaneous prominence
seen on the back of the wrist when the hand is pronated.

The tubercle of the navicular (scaphoid) and the greater multangular
(trapezium) can be felt between the radial styloid and the ball of the
thumb, a little below the radial styloid; and the pisiform and hook of
the hamatum (unciform) are palpable, slightly below and in front of
the ulnar styloid.

In examining an injured wrist, the different bony points should be
located, and their relative positions to one another and to the
adjacent joints noted; and the shape, position, and relations of any
unnatural projection or depression observed, using the wrist on the
other side as the normal standard for comparison. The power and range
of movement--active and passive--at the various joints should also be
tested.

FRACTURE OF THE LOWER END OF THE RADIUS

#Colles' Fracture.#--This injury, which was described by Colles of
Dublin in 1814, is one of the commonest fractures in the body, and is
especially frequent in women beyond middle age. It is almost
invariably the result of a fall on the palm of the hand, in the
three-quarters pronated position, the force being received on the ball
of the thumb, and tra