Flexion also may produce a firm end-feel if the muscle mass of the thenar eminence is poorly developed, but the end-feel for this motion is generally soft as long as sufficient thenar muscle mass is present. These so-called extrinsic ligaments of the wrist include the posteriorly located dorsal radiocarpal ligaments (Fig. Align proximal arm with the lateral mid-line of the ulna, using the olecranon and ulnar styloid processes. Hold your _____ hand in front of you with your palm down and elbow bent. Hand and Wrist Exercises: Wrist Flexion. CAPSULAR PATTERN Only gold members can continue reading. The volar plates are fibrocartilaginous discs that reinforce the joint, resist hyperextension, and provide an expanded articular surface for the metacarpal heads.25 The volar plates of the second through fifth MCP joints are interconnected via the deep transverse metacarpal ligaments23 (Fig. The capsular pattern for the wrist joint reflects an equal limitation of flexion and extension. Adjustable through 140° total extension. Wrist Flexion: Dorsal Alignment Each finger possesses two IP joints: a proximal interphalangeal joint (PIP), which consists of the articulation of the convex head of the proximal phalanx with the concave base of the middle phalanx, and a distal interphalangeal joint (DIP), which consists of the articulation of the convex head of the middle phalanx with the concave base of the distal phalanx (see Fig. In a study of 54 subjects, Marshal et al. Figures 5-7 through 5-9 illustrate motions of the wrist and hand used to perform selected functional activities. ANATOMY Each MCP joint is reinforced along its sides by a pair of collateral ligaments and along its volar surface by a volar plate. On the basis of data collected in this study, the authors concluded that only a small percentage of the total ROM of the fingers was required for functional activities. Before beginning, read through all the instructions. The capsular pattern is the same for the MCP joints and the IP (PIP and DIP) joints. 5-4). MCP abduction ROM . 5-5 Motions of the first carpometacarpal joint. RANGE OF MOTION AND FUNCTIONAL ACTIVITY The standard technique for measuring MCP and IP joint flexion is performed with the goniometer positioned over the dorsal surface of the joint being examined.1,7 Extension of the MCP and IP joints may be measured with the goniometer positioned over the dorsal or volar surface of the joint. The functions studied by Safaee-Rad and colleagues were limited to feeding activities in a group of 10 healthy adult men aged 20 to 29 years, which were analyzed using a three-dimensional (3D) motion analysis system. Bony landmarks for goniometer alignment (lateral epicondyle of humerus, lunate, dorsal midline of third metacarpal) indicated by red line and dots. 5-1 Bony anatomy of the radiocarpal and midcarpal joints. Ligamentous reinforcement of the wrist—palmar view. Limitation of MCP joint extension is produced by tension in the anterior joint capsule and volar plate. 5-4). /*
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