Deep space infections occur in one of the three anatomically defined potential spaces within the hand.
- Thenar, mid-palmar and hypothenar spaces
- Interdigital subfascial web space
- Forearm space of parona
Deep hand space | Dorsal border | Volar border | Ulnar border | Radial border | Remarks |
Thenar | Adductor pollicis | Palmar aponeurosis | Medial palmar septum | Middle palmar septum | FPL within synovial sheath, FDP and FDS for index finger, 1st lumbrical, Radial bursa, Palmar digital vessels of thumb and lateral side of index finger – these can be considered as contents or volar border |
Mid-palmar | 3rd, 4th and 5th metacarpals with fascia covering 3rd and 4th interossei | Palmar aponeurosis | Middle palmar septum | Lateral palmar septum | Flexor tendons of 3rd-5th fingers, 2nd-4th lumbricals, Superficial palmar arch, Digital nerves and vessels of medial 3 and 1/2 fingers, Ulnar bursa – these can be considered as contents or volar border |
Hypothenar | 5th metacarpal | Palmar aponeurosis | Lateral palmar septum | Hypothenar muscles | |
Dorsal subaponeurotic | Extensor tendons and dorsal aponeurosis | Metacarpals and dorsal fascia of interossei | |||
Interdigital subfascial | Dorsal hand fascia and skin | Palmar fascia | Metacarpophalangeal joint and extensor tendon | Metacarpophalangeal joint and extensor tendon | |
Parona | Digital flexor tendons | Pronator quadratus | Flexor carpi ulnaris | Flexor pollicis longus | Continuous with midpalmar space |