Metacarpus – Anatomy and Conditions of the Hand
The metacarpus, or palm of the hand, consists of five metacarpal bones connecting the wrist to the fingers. It forms the bony framework of the hand.
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The metacarpus, or palm of the hand, consists of five metacarpal bones connecting the wrist to the fingers. It forms the bony framework of the hand.
What Is the Metacarpus?
The metacarpus is the central region of the human hand, located between the wrist (carpus) and the fingers (phalanges). It is composed of five long, slender bones known as the metacarpal bones (metacarpals I–V), which form the skeletal framework of the palm and dorsum of the hand. The metacarpus plays a crucial role in gripping, holding, and fine motor activities.
Anatomy of the Metacarpus
Each of the five metacarpal bones is divided into three sections:
- Base (basis ossis metacarpi): The proximal end, which articulates with the carpal bones of the wrist.
- Shaft (corpus): The elongated middle portion of the bone.
- Head (caput): The distal end, which forms the metacarpophalangeal (MCP) joint with the proximal phalanx of the corresponding finger. The heads are palpable as the knuckles on the back of the hand.
The first metacarpal (thumb) is shorter and more robust than the other four. Metacarpals II through V decrease slightly in length from the index finger to the little finger. The spaces between the metacarpal bones are occupied by the interosseous muscles, which are essential for finger spreading and flexion.
Function of the Metacarpus
The metacarpus serves several important biomechanical functions:
- Transmitting forces between the wrist and the fingers
- Enabling gripping, holding, and fine motor movements
- Forming the transverse arch of the palm
- Providing attachment points for hand muscles and tendons
Common Conditions and Injuries
Metacarpal Fracture
Metacarpal fractures are among the most common hand injuries. A particularly well-known example is the boxer fracture, a fracture of the neck of the fifth metacarpal, typically caused by striking a hard surface with a closed fist. Symptoms include pain, swelling, and restricted movement. Treatment depends on severity and may be conservative (splinting) or surgical.
Rheumatoid Arthritis and Osteoarthritis
The metacarpophalangeal joints are frequently affected by rheumatoid arthritis, leading to swelling, pain, and eventual joint deformity. Degenerative changes (osteoarthritis) can also affect the MCP joints over time.
Dupuytren Contracture
Dupuytren contracture involves thickening and shortening of the palmar fascia, which originates in the area of the metacarpus and can cause progressive flexion contracture of the fingers.
Enchondroma
Enchondromas are benign cartilaginous tumors that commonly occur in the short tubular bones of the hand, including the metacarpals. They are often asymptomatic but may weaken the bone and lead to pathological fractures.
Diagnosis
The following diagnostic methods are used to evaluate the metacarpus:
- X-ray of the hand: The standard method for assessing fractures, joint changes, and bone structure.
- Computed tomography (CT): Used for complex fractures or ambiguous findings.
- Magnetic resonance imaging (MRI): Used to assess soft tissues, tendons, and ligaments surrounding the metacarpal bones.
- Ultrasound: Useful for rapid assessment of tendon sheaths and inflammatory changes.
References
- Standring S. (ed.) - Gray's Anatomy: The Anatomical Basis of Clinical Practice. 42nd edition. Elsevier, 2021.
- Berger R.A., Weiss A.P.C. (eds.) - Hand Surgery. Lippincott Williams & Wilkins, Philadelphia, 2004.
- Meals R.A., Meals C.M. - Hand fractures: A review of current treatment strategies. Journal of Hand Surgery, 2013; 38(5): 1021–1031.
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