Surgery of the Hand

There are a number of anatomically unique spaces and compartments in the hand. Gaining an understanding of these important structures is essential for accurate diagnosis, management, and prediction of the spread of infection in the hand. Typically, the proximal extent of the sheath in the thumb and little finger is more proximal than the flexor tendon sheaths in the other three fingers. Additionally, these sheaths may communicate with the radial and ulnar bursae, respectively. The radial and ulnar bursae also communicate with each other at the level of the palm and wrist. Tendon sheath infections of the little finger and thumb can track into each other through this communication. This explains the formation of a horseshoe abscess as a rare variant of flexor tenosynovitis in the hand. Horseshoe abscesses are well known due to their anatomic characteristics. However, there are few clinical reports of such occurrences. Also, such a case has not been reported in the Korean literature. This rare type of infection was Acute Horseshoe Abscess of the Hand after Local Steroid Injection: A Case Report