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Anatomy of the Wrist and Hand

Anterior View

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Posterior View

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Physiologic (Osteokinematic) Motions of the Wrist and Hand

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Joint Normal ROM Normal End Feel(s) Abnormal End Feel(s)
Distal radioulnar

Pronation = 90°

Supination = 90°

Pronation = capsular

Supination = capsular

 
Radiocarpal

Flex = 60°–80°

Ext = 60°–70°

RD/UD = 20°–30°

Flex = firm/ligamentous/elastic

Ext = firm/ligamentous/elastic

RD = bony

UD = firm/bony

Capsular = pronation & supination equally restricted
Intercarpal

Flex with RC jt = 60°–80°

Ext with RC jt = 60°–80°

RD/UD with RC jt = 20°–30°

Flex = firm/ligamentous/elastic

Ext = firm/ligamentous/elastic

RD = bony

UD = firm/bony

 
CMC thumb

Flex = 45°–50°

Ext = 70°-80°

Abd = 70°

Elastic

Capsular = abd > ext

MCP thumb Flex = 75°–90°

Flex = bony/firm/ligamentous/elastic

Ext = firm/elastic

 
MCP 2–5 Flex = 90°

Flex = elastic/bony/firm/ ligamentous

Ext = elastic/capsular/ ligamentous

Abd = firm/ligamentous

 
IP 2–5

PIP flex = 100°

DIP flex = 80°

PIP flex = firm/bony/elastic

PIP ext = firm/ligamentous/ elastic

DIP flex = firm/ligamentous/ elastic

DIP ext = firm/ligamentous/ elastic

 

Accessory (Arthrokinematic) Motions of the Wrist and Hand

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Arthrology Arthrokinematics
Distal Radioulnar

Concave surface:

Ulnar notch of radius

Convex surface:

Head of ulna

To facilitate pronation:

Radius rolls & glides medially over ulna

To facilitate supination:

Radius rolls & glides laterally over ulna

Radiocarpal/Intercarpal

Concave surface:

Radius & R/U disk

To facilitate wrist flexion:

Proximal carpal rolls anterior & glides posterior on radius with distal carpal rolling anterior & gliding posterior on proximal carpal

To facilitate ext:

Proximal carpal rolls posterior & glides anterior & on radius with distal carpal rolling posterior & gliding anterior on proximal carpal

Convex surface:

Proximal carpals

To facilitate radial deviation:

Proximal carpal rolls lateral & glides medial on radius with distal carpal rolling lateral & gliding medial on proximal carpal

To facilitate ulnar deviation:

Proximal carpal rolls medial & glides lateral on radius with distal carpal rolling medial & gliding lateral on proximal carpal

CMC 2–5

Concave surface:

Base of metacarpals

To facilitate thumb flex:

MC rolls & glides medial on trapezium

To facilitate thumb ext:

MC rolls & glides lateral on trapezium

CMC thumb

Convex surface:

Distal row of carpals

To facilitate thumb abd:

MC rolls proximal & glides distal on trapezium

To facilitate thumb add:

MC rolls distal & glides proximal on trapezium

MCP 2–5

Concave surface:

Base of proximal phalanx

To facilitate flex:

Proximal phalanx rolls & glides anterior on MC

To facilitate ext:

Proximal phalanx rolls & glides posterior on MC

MCP

thumb

Convex surface:

Head of metacarpal

To facilitate thumb flex:

Distal phalanx rolls & glides anterior on the proximal phalanx

To facilitate thumb ext:

Distal phalanx ...

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