| The bones of the hand and wrist, which are linked by synovial joints, provide a mobile yet stable framework that is crucial for strenuous work and fine manipulative activity. A built-in mechanism of self-preservation provides this complex apparatus with the ability to sustain a lifetime of use. Injury or disease can have an adverse effect on joint structure and metabolism, resulting in painful impairment of hand function.
Although there are a variety of diseases that are caused by different agents, the basic pathologic processes are the same. Knowledge of the basic science of bone and joint is critical to the comprehension of the mechanisms that are responsible for the development of adverse changes. The first part of this chapter describes the organization and physiology of bone and synovial joints. The changes in these tissues in response to four basic pathological conditions—injury, degeneration, inflammation, and infection—are then detailed. Within each disorder, the fundamental principles of therapeutic interventions are also discussed to maintain clinical relevance. |
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