Fig. 6-20 Various views of the hand. A and B, The forearm and hand in supination (A) and pronation (B). C, The hand of a child. Note the epiphyses for the lower ends of the radius and ulna and for the base of the first metacarpal and an accessory epiphysis for the base of the second metacarpal. D, The hand of a child. The pisiform does not yet show. Note the epiphyses for the metacarpals and phalanges. E and F, The index finger in extension (E) and flexion (F). Note the shift in position (relative to the heads of the proximal and middle phalanges) of the bases of the middle and distal phalanges. (A, B, E, and F, Courtesy of S. F. Thomas, M.D., Palo Alto Medical Clinic, Palo Alto, California. C, Courtesy of J. Lofstrom, M.D., Detroit Memorial Hospital, Detroit, Michigan.)Click for high resolution image.