The Wrist, or rather the upper and lower carpal joints, except in cases of sprain due to excessive palmar flexion, which are not uncommon and arc easily cured, generally comes under treatment as a result of the typical fracture of the radius. Dislocations of the wrist are exceedingly rare.

Fractures of the Radius, where a perfect reduction with the best possible correction is specially desirable, provide a good opportunity of comparing the value of different kinds of fixation apparatus. If plaster of Paris is used, as sometimes happens, shortening of the muscles, serious shrinking of the capsule, and severe disturbances of function often result. When the ordinary pistol splint is used, which only reaches as far as the heads of the metacarpal bones and so allows flexion and extension of the fingers, and which in its simplicity forms the very best support for these fractures, it leaves after the usual three weeks, if it has been properly applied, a condition which is easily restored to the normal. Progress is still more satisfactory if eight days after the splints are put on they are taken off twice daily while a little careful effleurage is applied to the whole of the lower arm. When the splints and sling are removed altogether fourteen days later the fractured part is quite firm and function is practically normal. At the most but a few treatments with frictions and passive movements are necessary to bring about complete recovery rather more quickly than would otherwise be the case.

In arthritis deformans and various forms of paralysis the joint takes up a position of ulnar flexion, sometimes with subluxation. Not much can be done by massage and gymnastics alone in these cases, but after surgical operation mechano-therapeutic treatment may restore to the patient a quite valuable joint.

During the treatment the masseur and patient sit opposite each other, one on each side of the plinth. Neither in massage nor gymnastics do we distinguish between the upper joint of the hand (the radiocarpal joint, the regular ellipsoid joint between radius and ulna on the one side, and the scaphoid, semilunar and cuneiform bones on the other) and the lower joint of the hand (the irregular ellipsoid joint between the three latter bones, and the trapezium, trapezoid, os magnum, and unciform). On the palmar and dorsal surfaces one gives frictions which extend over both joints, and when the masseur, with his fingers inserted between those of the patient's hand of the same side and with his own and the patient's elbows supported on the plinth, gives passive movements, palmar and dorsal flexion, radial and ulnar flexion, and circumduction take place in both joints, though their axes do not coincide, but form an acute angle with one another.

When atrophic shortening in the extensors of the fingers hinders flexion, it is possible, by means of strong slow flexions involving partial tearing of the extensors, to stretch them to their full length and then by effleurage on the dorsal surface of the forearm to assist their recovery.