American practice of surgery : a complete system of the science and art of surgery . remembered that this spacelies deep in the palm, just above the adductor transversus. Fifth, the middle palmar space, with its three diverticula below along thelumbrical muscles, limited by the middle metacarpal bone upon the radialside, overlapped by the ulnar bursa upon the ulnar side, and separated fromthe thenar space by a partition which is very firm everywhere except at the proximal end, where it is rather , Kecessus I sT;eiJ°™!s thin. A small isthmus can befound leading from the prox-imal end of the spa
American practice of surgery : a complete system of the science and art of surgery . remembered that this spacelies deep in the palm, just above the adductor transversus. Fifth, the middle palmar space, with its three diverticula below along thelumbrical muscles, limited by the middle metacarpal bone upon the radialside, overlapped by the ulnar bursa upon the ulnar side, and separated fromthe thenar space by a partition which is very firm everywhere except at the proximal end, where it is rather , Kecessus I sT;eiJ°™!s thin. A small isthmus can befound leading from the prox-imal end of the space underthe tendons and ulnar bursaat the wrist up into the fore-arm. Infections of the joints ofthe middle and ring fingers, andof the radial side of the littlefinger, are capable of conveyingcontamination to the middlepalmar space. The thenar space might re-ceive infection from the indexfinger and the ulnar side of thethumb. Suppurative arthritis of theto involvement of the hypo- Kecessusform isferiorulnar„ Joi,;fM Triangular\P] fibro-cartilagp M Trapezoid Trapezium. Fig. 303.—Coronal Section (diagrammatic) through theRadio-carpal, Carpal. Carpo-metacarpal, and Intermeta-carpal Joints, to Show Joint Cavities and Interosseous Lig-aments. (From Cunninghams Textbook of Anatomy.) distal joint of the thumb may give risethenar space. Infections of the middle and ring fingers may lead to involvement of thedorsal subaponeurotic space. Involvement of the dorsal subcutaneous space is possible in any infection ofthe fingers or thumb. From the anatomical details mentioned above it naturally follows, accord-ing to Kanavel, that, if the middle palmar space is to be opened, an incisionshould be made in the skin over the metacarpal space between the middleand ring fingers, just where the middle palmar crease crosses said space. Theincision may safely be made through the palmar aponeurosis, but the subjacent les should be perforated with an artery forceps the point of which shou
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1900, bookyear1906
