Web Space Infections In Hand

Infections occur frequently in the hand as it is used frequently. The occurrence is more common in people with low immune status.

Web spaces are three triangular spaces in the hand between the four divisions of the palm (between the fingers). These spaces are filled with subcutaneous lose fat and metacarpal bones.

Causes

There may be many reasons for the development of inter-digital web space infections such as injuries (more commonly puncture wound), spread of palmar space infection or spread from the infection from bones of the hand.

Symptoms

The infection may be localized with marked systemic symptoms. The common symptoms include much severe pain and swelling of palm in the region of inter-digital web spaces. The swelling is extremely tender and hot to touch.

Web space infections produce gross oedema (of pitting type) of the space and extend over the back of the hand. Pus may form and move across the palmar surface of the base of the fingers from one web space to the next. The systemic symptoms include fever, malaise, lethargy and tiredness.

Signs

Finger separation sign is positive, that means that the adjacent fingers are separated due to the presence of oedema. This occurs in case of severe infection and is a very useful sign.

The signs of inflammation extend from web space to the base of the adjacent fingers and also to the back of the hand.

Localized tenderness is present with typical pitting type of oedema over the back of the hand.

Treatment

The cavity must be treated like any other cavity. Skin incision and drainage of pus is done under local anaesthesia. Antibiotics are prescribed to treat the underlying cause.

Complications

If left untreated, the infection may penetrate to the adjacent web spaces or may also lead to stiffness at meta-carpo-phalangeal joints. Sometimes, the infections of the hand may spread to the heart even via blood.