KnotesFree Orthopaedic & FRCS notes, viva stations and higher order SBAs

Hand origins and insertions

High YieldHand & WristthinKbox SBA

Thenar muscles

  • Abductor pollicis brevis: flexor retinaculum, scaphoid, trapezium → base of proximal phalanx of thumb
  • Flexor pollicis brevis: flexor retinaculum / trapezium and trapezoid-capitate region → base of proximal phalanx
  • Opponens pollicis: flexor retinaculum and trapezium → first metacarpal

Hypothenar muscles

  • Abductor digiti minimi: pisiform → base of proximal phalanx of little finger
  • Flexor digiti minimi brevis: hook of hamate and flexor retinaculum → base of proximal phalanx
  • Opponens digiti minimi: hook of hamate and flexor retinaculum → fifth metacarpal

Interossei

  • Dorsal interossei abduct the fingers (DAB)
  • Palmar interossei adduct the fingers (PAD)

Lumbricals

Originate from FDP tendons and insert into the extensor expansion.

Diagram

Hand origins and insertions

Written/reviewed by Kishore Puthezhath

Professor of Orthopaedics and Consultant Paediatric Orthopaedic Surgeon

FRCS (Tr & Orth) revision resource

Reviewed: September 2026