Inservice Exam 2005
Soft Tissue Infection

In a patient with infection of the index finger, drainage is most likely to flow proximally into which of the following spaces?

(A) Midpalmar space
(B) Parona’s space
(C) Radial bursa
(D) Thenar space
(E) Ulnar bursa


The correct response is Option D.
Infections of the index finger drain from the flexor sheath proximally into the thenar space. Infections of the long, ring, and small fingers drain into the midpalmar space. The radial and ulnar bursae communicate by Parona’s space, which lies deep to the pronator muscle.

References:
1. Jebson PJ. Deep subfascial space infections. Hand Clin. 1998;14(4):557-566.
2. Lille S, Hayakawa T, Neumeister MW, et al. Continuous postoperative catheter irrigation is not necessary for the treatment of suppurative flexor tenosynovitis. J Hand Surg [Br]. 2000;25(3):304-307.
3. Gutowski KA, Ochoa O, Adams WP Jr. Closed-catheter irrigation is as effective as open drainage for treatment of pyogenic flexor tenosynovitis. Ann Plast Surg. 2002;49(4):350-354.