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# 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 points

- It separates two potential spaces: the dorsal subcutaneous space above it and the dorsal subaponeurotic space between the extensor tendons and the metacarpals
- Lymph from the palm drains to the back of the hand, so a palmar infection often shows as dorsal swelling
- The extensor tendons lie just under it and thin skin, so lacerations over the metacarpals (zone VI) often cut them

## 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](https://durgical.com/en/anatomy/skin/); the [back-of-hand veins](https://durgical.com/en/anatomy/dorsal-venous-network-of-the-hand/) (dorsal venous network), the [superficial radial nerve](https://durgical.com/en/anatomy/superficial-branch-of-the-radial-nerve/) and the [dorsal hand nerves](https://durgical.com/en/anatomy/dorsal-branch-of-the-ulnar-nerve-and-dorsal-digital-nerves/) from the [ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/)

**Deep**
[Extensor tendons](https://durgical.com/en/anatomy/extensor-digitorum-tendons/) with their juncturae tendinum; deeper, the subaponeurotic space, the dorsal interossei and the metacarpals

**Above**
Continuous with the [extensor retinaculum](https://durgical.com/en/anatomy/extensor-retinaculum-of-the-wrist/) 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.

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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

- [Distal phalanx, middle finger](https://durgical.com/en/anatomy/distal-phalanx-of-the-middle-finger/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Hand Compartments](https://www.ncbi.nlm.nih.gov/books/NBK532942/).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/dorsal-fascia-of-the-hand/