In human anatomy, the wrist is variously defined as (1) the

carpus In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carpal ...

or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carpal bones." (2) the wrist joint or radiocarpal joint, the joint between the

radius In classical geometry, a radius ( : radii) of a circle or sphere is any of the line segments from its center to its perimeter, and in more modern usage, it is also their length. The name comes from the latin ''radius'', meaning ray but also the ...

and the

and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as ''wrist joints''. "With the large number of bones composing the wrist (ulna, radius, eight carpas, and five metacarpals), it makes sense that there are many, many joints that make up the structure known as the wrist." This region also includes the

carpal tunnel In the human body, the carpal tunnel or carpal canal is the passageway on the palmar side of the wrist that connects the forearm to the hand. The tunnel is bounded by the bones of the wrist and flexor retinaculum from connective tissue. Norma ...

, the

anatomical snuff box The anatomical snuff box or snuffbox or foveola radialis is a triangular deepening on the radial, dorsal aspect of the hand—at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor. The name originates ...

, bracelet lines, the flexor retinaculum, and the extensor retinaculum. As a consequence of these various definitions, fractures to the carpal bones are referred to as carpal fractures, while fractures such as

distal radius fracture A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Symptoms include pain, bruising, and rapid-onset swelling. The ulna bone may also be broken. In younger people, thes ...

are often considered fractures to the wrist.

Structure

The distal radioulnar joint is a pivot joint located between the bones of the

forearm The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is most often used to describe the entire appendage of the upper limb, but which in ...

, the

and

ulna The ulna (''pl''. ulnae or ulnas) is a long bone found in the forearm that stretches from the elbow to the smallest finger, and when in anatomical position, is found on the medial side of the forearm. That is, the ulna is on the same side of t ...

. Formed by the head of the ulna and the

ulnar notch of the radius The articular surface for the ulna is called the ulnar notch (sigmoid cavity) of the radius; it is in the distal radius, and is narrow, concave, smooth, and articulates with the head of the ulna forming the distal radioulnar joint The distal rad ...

, this joint is separated from the radiocarpal joint by an articular disk lying between the radius and the styloid process of the ulna. The capsule of the joint is lax and extends from the inferior sacciform recess to the ulnar shaft. Together with the

proximal radioulnar joint The proximal radioulnar articulation, also known as the proximal radioulnar joint (PRUJ), is a synovial pivot joint between the circumference of the head of the radius and the ring formed by the radial notch of the ulna and the annular ligament ...

, the distal radioulnar joint permits pronation and supination. The radiocarpal joint or wrist joint is an ellipsoid joint formed by the radius and the

articular disc The articular disk (or disc) is a thin, oval plate of fibrocartilage present in several joints which separates synovial cavities. This separation of the cavity space allows for separate movements to occur in each space. The presence of an articula ...

proximally and the proximal row of carpal bones distally. The carpal bones on the ulnar side only make intermittent contact with the proximal side — the triquetrum only makes contact during ulnar abduction. The capsule, lax and un-branched, is thin on the dorsal side and can contain synovial folds. The capsule is continuous with the midcarpal joint and strengthened by numerous ligaments, including the palmar and

dorsal radiocarpal ligament The dorsal radiocarpal ligament (posterior ligament) is less thick and strong than its volar counterpart, and has a proximal attachment to the posterior border of the distal radius. Its fibers run medially and inferiorly to form a distal attachment ...

s, and the

ulnar The ulna (''pl''. ulnae or ulnas) is a long bone found in the forearm that stretches from the elbow to the smallest finger, and when in anatomical position, is found on the medial side of the forearm. That is, the ulna is on the same side of t ...

and radial collateral ligaments. The parts forming the radiocarpal joint are the lower end of the

and under surface of the

articular disk The articular disk (or disc) is a thin, oval plate of fibrocartilage present in several joints which separates synovial cavities. This separation of the cavity space allows for separate movements to occur in each space. The presence of an articula ...

above; and the

scaphoid The scaphoid bone is one of the carpal bones of the wrist. It is situated between the hand and forearm on the thumb side of the wrist (also called the lateral or radial side). It forms the radial border of the carpal tunnel. The scaphoid bone i ...

lunate Lunate is a crescent or moon-shaped microlith. In the specialized terminology of lithic reduction, a lunate flake is a small, crescent-shaped flake removed from a stone tool during the process of pressure flaking. In the Natufian period, a lun ...

, and

triquetral The triquetral bone (; also called triquetrum, pyramidal, three-faced, and formerly cuneiform bone) is located in the wrist on the medial side of the proximal row of the carpus between the lunate and pisiform bones. It is on the ulnar side of the ...

bones below. The articular surface of the radius and the undersurface of the

form together with a transversely elliptical concave surface, the receiving cavity. The superior articular surfaces of the scaphoid, lunate, and triquetrum form a smooth convex surface, the

condyle A condyle (;Entry "condyle"
in
Carpal bones of the hand: * ''Proximal:'' A=

Scaphoid The scaphoid bone is one of the carpal bones of the wrist. It is situated between the hand and forearm on the thumb side of the wrist (also called the lateral or radial side). It forms the radial border of the carpal tunnel. The scaphoid bone i ...

, B=

Lunate Lunate is a crescent or moon-shaped microlith. In the specialized terminology of lithic reduction, a lunate flake is a small, crescent-shaped flake removed from a stone tool during the process of pressure flaking. In the Natufian period, a lun ...

, C= Triquetrum, D=

Pisiform The pisiform bone ( or ), also spelled pisiforme (from the Latin ''pisifomis'', pea-shaped), is a small knobbly, sesamoid bone that is found in the wrist. It forms the ulnar border of the carpal tunnel. Structure The pisiform is a sesamoid bone, ...

* ''Distal:'' E= Trapezium, F=

Trapezoid A quadrilateral with at least one pair of parallel sides is called a trapezoid () in American and Canadian English. In British and other forms of English, it is called a trapezium (). A trapezoid is necessarily a convex quadrilateral in Eu ...

, G=

Capitate The capitate bone is a bone in the human wrist found in the center of the carpal bone region, located at the distal end of the radius and ulna bones. It articulates with the third metacarpal bone (the middle finger) and forms the third carpomet ...

, H=

Hamate The hamate bone (from Latin hamatus, "hooked"), or unciform bone (from Latin ''uncus'', "hook"), Latin os hamatum and occasionally abbreviated as just hamatum, is a bone in the human wrist readily distinguishable by its wedge shape and a hook-l ...

In the hand proper a total of 13 bones form part of the wrist: eight carpal bones—

pisiform The pisiform bone ( or ), also spelled pisiforme (from the Latin ''pisifomis'', pea-shaped), is a small knobbly, sesamoid bone that is found in the wrist. It forms the ulnar border of the carpal tunnel. Structure The pisiform is a sesamoid bone, ...

, trapezium,

trapezoid A quadrilateral with at least one pair of parallel sides is called a trapezoid () in American and Canadian English. In British and other forms of English, it is called a trapezium (). A trapezoid is necessarily a convex quadrilateral in Eu ...

capitate The capitate bone is a bone in the human wrist found in the center of the carpal bone region, located at the distal end of the radius and ulna bones. It articulates with the third metacarpal bone (the middle finger) and forms the third carpomet ...

, and

hamate The hamate bone (from Latin hamatus, "hooked"), or unciform bone (from Latin ''uncus'', "hook"), Latin os hamatum and occasionally abbreviated as just hamatum, is a bone in the human wrist readily distinguishable by its wedge shape and a hook-l ...

— and five metacarpal bones—the

first First or 1st is the ordinal form of the number one (#1). First or 1st may also refer to: *World record, specifically the first instance of a particular achievement Arts and media Music * 1$T, American rapper, singer-songwriter, DJ, and rec ...

, second, third, fourth, and

fifth metacarpal bone The fifth metacarpal bone (metacarpal bone of the little finger or pinky finger) is the most medial and second-shortest of the metacarpal bones. Surfaces It presents on its base one facet on its superior surface, which is concavo-convex and artic ...

s. The

midcarpal joint The midcarpal joint is formed by the scaphoid, lunate, and triquetral bones in the proximal row, and the trapezium, trapezoid, capitate, and hamate bones in the distal row. The distal pole of the scaphoid articulates with two trapezial bones a ...

is the S-shaped joint space separating the proximal and distal rows of carpal bones. The

intercarpal joints The intercarpal joints (joints of the carpal bones of the wrist) can be subdivided into three sets of joints (also called ''articulations''): Those of the proximal row of carpal bones, those of the distal row of carpal bones, and those of the two ...

, between the bones of each row, are strengthened by the radiate carpal and

pisohamate ligament The pisohamate ligament is a ligament in the hand. It connects the pisiform to the hook of the hamate. It is a prolongation of the tendon of the flexor carpi ulnaris. It serves as part of the origin for the abductor digiti minimi. It also forms t ...

s and the palmar, interosseous, and

dorsal intercarpal ligament The dorsal intercarpal ligament consists of a series of fibrous bands that extend transversely across the dorsal surfaces of the carpal The carpal bones are the eight small bones that make up the wrist (or carpus) that connects the hand to the ...

s. Some degree of mobility is possible between the bones of the proximal row while the bones of the distal row are connected to each other and to the metacarpal bones —at the

carpometacarpal joint The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones. The CMC joint of the thumb or the first CMC joint, also known as the trapeziometaca ...

s— by strong ligaments —the pisometacarpal and palmar and dorsal carpometacarpal ligament— that makes a functional entity of these bones. Additionally, the joints between the bases of the metacarpal bones —the

intermetacarpal articulations The intermetacarpal joints are in the hand formed between the metacarpal bones. The bases of the second, third, fourth and fifth metacarpal bones articulate with one another by small surfaces covered with cartilage. The metacarpal bones are conn ...

— are strengthened by

dorsal Dorsal (from Latin ''dorsum'' ‘back’) may refer to: * Dorsal (anatomy), an anatomical term of location referring to the back or upper side of an organism or parts of an organism * Dorsal, positioned on top of an aircraft's fuselage * Dorsal c ...

, interosseous, and

palmar intermetacarpal ligament Palmar may refer to: Anatomy, relating to the palm of the hand * Palmar aponeurosis, deep fascia connecting and within the muscles of the palm * Palmar arches (disambiguation), various combinations of arteries in the hand and arm * Palmar arte ...

s. The earliest carpal bones to ossify are

capitate bone The capitate bone is a bone in the human wrist found in the center of the carpal bone region, located at the distal end of the radius and ulna bones. It articulates with the third metacarpal bone (the middle finger) and forms the third carpomet ...

and

hamate bone The hamate bone (from Latin hamatus, "hooked"), or unciform bone (from Latin ''uncus'', "hook"), Latin os hamatum and occasionally abbreviated as just hamatum, is a bone in the human wrist readily distinguishable by its wedge shape and a hook-l ...

in the first six months of an infant life.

Articulations

The radiocarpal, intercarpal, midcarpal, carpometacarpal, and intermetacarpal joints often intercommunicate through a common synovial cavity.

Articular Surfaces

It has two articular surfaces named, proximal and distal articular surfaces respectively. The proximal articular surface is made up of the lower end of the radius and a triangular articular disc of the inferior radio-ulnar joint. On the other hand, the distal articular surface is made up of proximal surfaces of the scaphoid, triquetral and lunate bones. Hand of embryo

Function

Movement

The extrinsic hand muscles are located in the forearm where their bellies form the proximal fleshy roundness. When contracted, most of the tendons of these muscles are prevented from standing up like taut bowstrings around the wrist by passing under the flexor retinaculum on the palmar side and the extensor retinaculum on the dorsal side. On the palmar side the carpal bones form the

, through which some of the flexor tendons pass in

tendon sheath A tendon sheath is a layer of synovial membrane around a tendon. It permits the tendon to stretch and not adhere to the surrounding fascia. It has two layers: * synovial sheath A synovial sheath is one of the two membranes of a tendon sheath wh ...

s that enable them to slide back and forth through the narrow passageway (see

carpal tunnel syndrome Carpal tunnel syndrome (CTS) is the collection of symptoms and signs associated with median neuropathy at the carpal tunnel. Most CTS is related to idiopathic An idiopathic disease is any disease with an unknown cause or mechanism of apparen ...

). Starting from the mid-position of the hand, the

movements Movement may refer to: Common uses * Movement (clockwork), the internal mechanism of a timepiece * Motion, commonly referred to as movement Arts, entertainment, and media Literature * "Movement" (short story), a short story by Nancy Fu ...

permitted in the wrist proper are (muscles in order of importance): * Marginal movements: radial deviation (abduction, movement towards the thumb) and ulnar deviation (adduction, movement towards the little finger). These movements take place about a dorsopalmar axis (back to front) at the radiocarpal and midcarpal joints passing through the capitate bone. ** Radial abduction (up to 20°): extensor carpi radialis longus,

abductor pollicis longus In human anatomy, the abductor pollicis longus (APL) is one of the extrinsic muscles of the hand. Its major function is to abduct the thumb at the wrist. Its tendon forms the anterior border of the anatomical snuffbox. Structure The abductor ...

extensor pollicis longus In human anatomy, the extensor pollicis longus muscle (EPL) is a skeletal muscle located dorsally on the forearm. It is much larger than the extensor pollicis brevis, the origin of which it partly covers and acts to stretch the thumb together w ...

flexor carpi radialis In anatomy, flexor carpi radialis is a muscle of the human forearm that acts to flex and (radially) abduct the hand. The Latin ''carpus'' means wrist; hence flexor carpi is a flexor of the wrist. Origin and insertion The flexor carpi radialis is ...

flexor pollicis longus The flexor pollicis longus (; FPL, Latin ''flexor'', bender; ''pollicis'', of the thumb; ''longus'', long) is a muscle in the forearm and hand that flexes the thumb. It lies in the same plane as the flexor digitorum profundus. This muscle is un ...

** Ulnar adduction (up to 30°):

extensor carpi ulnaris In human anatomy, the extensor carpi ulnaris is a skeletal muscle located on the ulnar side of the forearm. The extensor carpi ulnaris acts to extend and adduct at the carpus/wrist from anatomical position. Being an extensor muscle, extensor carp ...

flexor carpi ulnaris The flexor carpi ulnaris (FCU) is a muscle of the forearm that flexes and adducts at the wrist joint. Structure Origin The flexor carpi ulnaris has two heads; a humeral head and ulnar head. The humeral head originates from the medial epicondyle of ...

extensor digitorum The extensor digitorum muscle (also known as extensor digitorum communis) is a muscle of the posterior forearm present in humans and other animals. It extends the medial four digits of the hand. Extensor digitorum is innervated by the posterior int ...

extensor digiti minimi The extensor digiti minimi (extensor digiti quinti proprius) is a slender muscle of the forearm, placed on the ulnar side of the extensor digitorum communis, with which it is generally connected. It arises from the common extensor tendon by a thi ...

* Movements in the plane of the hand: flexion (palmar flexion, tilting towards the palm) and extension (dorsiflexion, tilting towards the back of the hand). These movements take place through a transverse axis passing through the capitate bone. Palmar flexion is the most powerful of these movements because the flexors, especially the finger flexors, are considerably stronger than the extensors. * Extension (up to 60°):

, extensor carpi radialis longus,

extensor carpi radialis brevis In human anatomy, extensor carpi radialis brevis is a muscle in the forearm that acts to extend and abduct the wrist. It is shorter and thicker than its namesake extensor carpi radialis longus which can be found above the proximal end of the exten ...

extensor indicis In human anatomy, the extensor indicis roprius'' is a narrow, elongated skeletal muscle in the deep layer of the dorsal forearm, placed medial to, and parallel with, the extensor pollicis longus. Its tendon goes to the index finger, which it ex ...

* Palmar flexion (up to 70°):

flexor digitorum superficialis Flexor digitorum superficialis (''flexor digitorum sublimis'') is an extrinsic flexor muscle of the fingers at the proximal interphalangeal joints. It is in the anterior compartment of the forearm. It is sometimes considered to be the deepest pa ...

flexor digitorum profundus The flexor digitorum profundus is a muscle in the forearm of humans that flexes the fingers (also known as digits). It is considered an extrinsic hand muscle because it acts on the hand while its muscle belly is located in the forearm. Together ...

* Intermediate or combined movements However, movements at the wrist can not be properly described without including movements in the distal radioulnar joint in which the rotary actions of supination and pronation occur and this joint is therefore normally regarded as part of the wrist.

Clinical significance

X-ray of normal wrist and wrist with dorsally tilted wrist joint

Wrist pain 300px, An illustration of wrist pain Wrist pain or open wrist is a type of syndrome that prevents the patient using their hand due to a painful wrist. The pain may be sharp, sometimes steadily increasing after trying to apply force. Typically pain ...

has a number of causes, including

, ganglion cyst,

tendinitis Tendinopathy, a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder (rotator cuff tendinitis, biceps tendinitis), elbow (tennis elbo ...

, and

osteoarthritis Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the w ...

. Tests such as Phalen's test involve

palmarflexion Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relativ ...

at the wrist. The hand may deviate at the wrist in some conditions, such as

rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are invol ...

Ossification Ossification (also called osteogenesis or bone mineralization) in bone remodeling is the process of laying down new bone material by cells named osteoblasts. It is synonymous with bone tissue formation. There are two processes resulting in ...

of the bones around the wrist is one indicator used in taking a

bone age Bone age is the degree of a person's skeletal development. In children, bone age serves as a measure of physiological maturity and aids in the diagnosis of growth abnormalities, endocrine disorders, and other medical conditions. As a person grows fr ...

. A ''wrist fracture'' usually means a fracture of the

distal radius The radius or radial bone is one of the two large bones of the forearm, the other being the ulna. It extends from the lateral side of the elbow to the thumb side of the wrist and runs parallel to the ulna. The ulna is usually slightly longer tha ...

History

Etymology

The

English English usually refers to: * English language * English people English may also refer to: Peoples, culture, and language * ''English'', an adjective for something of, from, or related to England ** English national ide ...

word "

wrist In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carp ...

" is

etymologically Etymology ()The New Oxford Dictionary of English (1998) – p. 633 "Etymology /ˌɛtɪˈmɒlədʒi/ the study of the class in words and the way their meanings have changed throughout time". is the study of the history of the form of words an ...

derived from the ancient

German German(s) may refer to: * Germany (of or related to) ** Germania (historical use) * Germans, citizens of Germany, people of German ancestry, or native speakers of the German language ** For citizens of Germany, see also German nationality law **Ge ...

word ''wristiz'' from which are derived modern German ''

rist Rist is a surname. Notable people with the surname include: * Boy Rist, Norwegian officer and WWII resistance fighter * Charles Rist (1874–1955), French economist * Gilbert Rist (born 1938), Swiss academic * Johann Rist (1607–1667), German dra ...

'' ("

instep The foot ( : feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made ...

", "wrist") and modern

Swedish Swedish or ' may refer to: Anything from or related to Sweden, a country in Northern Europe. Or, specifically: * Swedish language, a North Germanic language spoken primarily in Sweden and Finland ** Swedish alphabet, the official alphabet used by ...

'' vrist'' ("instep", "

ankle The ankle, or the talocrural region, or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joi ...

"). The base ''writh-'' and its variants are associated with

Old English Old English (, ), or Anglo-Saxon, is the earliest recorded form of the English language, spoken in England and southern and eastern Scotland in the early Middle Ages. It was brought to Great Britain by Anglo-Saxon settlers in the mid-5th c ...

words "

wreath A wreath () is an assortment of flowers, leaves, fruits, twigs, or various materials that is constructed to form a circle . In English-speaking countries, wreaths are used typically as household ornaments, most commonly as an Advent and Chri ...

", "

wrest Wrest Park is a Rural, country Estate (house), estate located in Silsoe, Bedfordshire, England. It comprises Wrest Park, a Grade I listed building, listed English country house, country house, and Wrest Park Gardens, also Grade I listed, forma ...

", and "

writhe In knot theory, there are several competing notions of the quantity writhe, or \operatorname. In one sense, it is purely a property of an oriented link diagram and assumes integer values. In another sense, it is a quantity that describes the amou ...

". The ''wr-'' sound of this base seems originally to have been symbolic of the action of twisting.

Additional images

File:Dissection of the human hand - 02.jpg, Wrist joint. Deep dissection. Posterior view. File:Slide5kaka.JPG, Wrist joint. Deep dissection. Posterior view. File:Slide2dsds.JPG, Wrist joint. Deep dissection.Anterior, palmar, view. File:Slide3dsds.JPG, Wrist joint. Deep dissection.Anterior, palmar, view.

Structure

Articulations

Articular Surfaces

Function

Movement

Clinical significance

History

Etymology

See also

Additional images

References

Sources

External links