CLINICAL ANATOMY OF PALMAR SPACES
• A number of fascial spaces in the region of hand are formed due to arrangement of
fasciae and fascial septa.
• Palmar spaces include:
a. Midpalmar space
b. Thenar space
c. Pulp space of the fingers
MID-PALMAR SPACE:
• Primarily infected by puncture wounds.
• May be involved secondarily due to infection spreading from digital synovial sheaths of
flexor tendons.
• Pus can be drained by an incision into 3rd or 4th web space, depending on where the pus
points.
THENAR SPACE:
• Primarily infected by puncture wounds.
• May be involved secondarily due to infection spreading from digital synovial sheath of
index finger.
• Pus can be drained by an
incision in the 1stweb space,
depending on where the pus
points.
PULP SPACE:
• The infection of pulp space
called WHITLOW.
• Increasing tension in the
space gives rise to severe
throbbing pain. • Infections can be drained by a lateral incision which opens all compartments and
prevents damage to the tactile tissue in front of finger.
• If neglected it can produce necrosis of distal 4/5th of the phalanx due to occlusion of
digital artery by the tension.
• The complete regeneration is possible because the proximal epiphyseal portion of
phalanx remains unaffected.
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