Dorsal hand fascia !
The dorsal fascia of the hand is a thin sheet on the back of the hand; it covers the extensor tendons.
Official name: Dorsal fascia of the hand
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What it is
A thin sheet over the extensor tendons on the back of the hand.
What it does
Covers the extensor tendons.
Key facts
- Where
- Back of the hand over the extensor tendons
- Function
- Covers the extensor tendons; continuous with the extensor retinaculum
Relations
- Superficial
- Thin, mobile skin; the back-of-hand veins (dorsal venous network), the superficial radial nerve and the dorsal hand nerves from the ulnar nerve
- Deep
- Extensor tendons with their juncturae tendinum; deeper, the subaponeurotic space, the dorsal interossei and the metacarpals
- Above
- Continuous with the extensor retinaculum at the wrist
- Below
- Blends with the extensor mechanism over the knuckles
How to find it
The extensor tendons stand out under the thin dorsal skin when the fingers are straightened; the fascia is the thin layer around them, opened in any dorsal approach to the metacarpals.
On imaging
Seen on ultrasound as a thin bright line over the extensor tendons. Ultrasound or MRI shows whether a collection on the back of the hand lies in the subcutaneous space above the fascia or in the subaponeurotic space below it, and can show a cut extensor tendon. Radiographs look for a foreign body, a fracture or, after a punch, a tooth injury into the knuckle joint.
Clinical notes
- In dorsal hand swelling the source of infection is often in the palm, which is examined first
- A dorsal subaponeurotic abscess is drained through dorsal incisions placed between the extensor tendons, sparing the sensory nerve branches
- Proximal to the juncturae tendinum, a cut extensor tendon may still allow some finger extension, which can hide the injury
Test yourself
Think of the answer, then tap the question to see it.
Which two potential spaces does the dorsal hand fascia separate?
The dorsal subcutaneous space above it and the dorsal subaponeurotic space between the extensor tendons and the metacarpals.
Why does a palmar infection often show as swelling over the dorsal hand fascia?
Lymph from the palm drains to the back of the hand, so the palm is examined first.
Why can a cut extensor tendon under the dorsal hand fascia be missed?
Proximal to the juncturae tendinum, some finger extension may still be possible, which hides the injury.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- fascia dorsalis manus TA2 2547
- Official Spanish (DeCS)
- Fascia dorsal de la mano
- English (TA2)
- Dorsal fascia of the hand
Related
Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Hand Compartments.
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Representative model, for educational purposes only.
