REIDER PART 119
Chapter 4 Hand and Wrist 109
Figurę 4-13. A, B, and C, Radial aspect of the hand. A, inter-phalangeal joint of the thumb; B, distal phalanx; C, proximal phalanx; D, first metacarpal; £, first metacarpophalangeal joint; F, basilar joint.
Wrist. Looking proximally from the base of the first metacarpal, the examiner encounters a hollow or depres-sion and then a slight prominence produced by the sty-loid process of the distal radius. The hollow marks an area often known as the anatomie snuffbox (Fig. 4-15). The anatomie snuffbox is bordered dorsally by the ten-don of the extensor pollicis longus and volarly by the adjacent tendons of the extensor pollicis brevis and abductor pollicis longus. The visibility of these tendons may be accentuated by asking the patient to extend the thumb forcefully.
The waist of the scaphoid bonę, the most common site for wrist fracture, lies deep to the anatomie snuffbox. Thus, puffy swelling and tenderness in the anatomie snuffbox following trauma suggests the possibility of a scaphoid fracture.
Volar (Palmar) Aspect
Fingers and Palm. Further rotating the patienfs fore-arm into the fully supinated position allows inspection of the palmar aspect of the hand and volar wrist. The pal-mar aspect of the normal hand is not fiat but marked by
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