Anatomy of Deep Palmar Spaces

Deep space infections occur in one of the three anatomically defined potential spaces within the hand.

  1. Thenar, mid-palmar and hypothenar spaces
  2. Interdigital subfascial web space
  3. Forearm space of parona
deep hand spaces schematic
Deep hand spaceDorsal borderVolar borderUlnar borderRadial borderRemarks
ThenarAdductor pollicisPalmar aponeurosisMedial palmar septumMiddle palmar septumFPL 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-palmar3rd, 4th and 5th metacarpals with fascia covering 3rd and 4th interosseiPalmar aponeurosisMiddle palmar septumLateral palmar septumFlexor 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
Hypothenar5th metacarpalPalmar aponeurosisLateral palmar septumHypothenar muscles
Dorsal subaponeuroticExtensor tendons and dorsal aponeurosisMetacarpals and dorsal fascia of interossei
Interdigital subfascialDorsal hand fascia and skinPalmar fasciaMetacarpophalangeal joint and extensor tendonMetacarpophalangeal joint and extensor tendon
ParonaDigital flexor tendonsPronator quadratusFlexor carpi ulnarisFlexor pollicis longusContinuous with midpalmar space

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