The pastern is part of the skeleton of the hand at the level of the palm.

Position. The pastern is one of the three regions of the skeleton of the hand (1).

Structure. Forming the skeleton of the palm of the hand, the pastern is made up of five long bones, named M1 to M5 (2). The metacarpal bones articulate at the back with the carpal bones and at the front with the phalanges, allowing the formation of the fingers.

Junctions. The bones and joints of the pastern are stabilized by ligaments and tendons. The metacarpophalangeal joints are consolidated by the collateral ligaments, as well as by the palmar plate (3).

Hand movements. Connected by the joints, the metacarpal bones are set in motion thanks to numerous tendons and muscles reacting to different nerve messages. In particular, they allow flexion and extension movements of the fingers as well as adduction and abduction movements of the thumb (2).

Gripping. The essential function of the hand, and in particular of the pastern, is grip, the ability of an organ to grasp objects (4). 

Metacarpal fractures. The pastern can be impacted and fractured. Extra-articular fractures must be distinguished from joint fractures involving the joint and requiring a thorough assessment of the lesions. The metacarpal bones can fracture from a fall with a closed fist or a heavy blow with the hand (5).

osteoporosis. This pathology can affect the pastern and constitutes a loss of bone density which is generally found in people over the age of 60. It accentuates bone fragility and promotes bills (6).

Arthritis. It corresponds to conditions manifested by pain in the joints, ligaments, tendons or bones, especially in the metacarpus. Characterized by the wear and tear of the cartilage protecting the bones of the joints, osteoarthritis is the most common form of arthritis. The joints of the hands can also be affected by inflammation in the case of rheumatoid arthritis (7). These conditions can lead to deformity of the fingers.

Prevention of shock and pain in the hand. To limit fractures and musculoskeletal disorders, prevention by wearing protection or learning appropriate gestures is essential.

Orthopedic treatment. Depending on the type of fracture, the installation of a plaster or a resin will be carried out to immobilize the hand.

Drug treatments. Depending on the condition diagnosed, certain drugs may be prescribed to regulate or strengthen bone tissue.

Surgical treatment. Depending on the type of fracture, surgery may be performed with the placement of pins or screw plates.

Physical examination. Initially, the clinical examination makes it possible to identify and assess the hand pain perceived by the patient.

Medical imaging exam. The clinical examination is often supplemented by an x-ray. In some cases, an MRI, CT scan, or arthrography may be done to assess and identify lesions. Scintigraphy or even bone densitometry can also be used to assess bone pathologies.

Communication tool. Hand gestures are often associated with speaking.