Infections of the hand and wrist: anatomical problems with surgical solutions

Infections of the hand and wrist are thankfully rare, but they present esoterically dependent on the specific structures involved. When underappreciated, they lead to delayed or incomplete management and destruction of highly specialized functional anatomy in the hand which results in significant disability. The general signs, symptoms and investigations for infections in the hand mirror infections elsewhere, but the variety of potential spaces in the hand mean there is no single sensitive indicator clinically, biochemically or radiologically. A high index of suspicion and understanding of the anatomy which affects the presentation, progression, treatment and complications of hand infections is required. This review describes the specific anatomy to be aware of to diagnose and manage hand infections completely, and highlights the near universal requirement for surgery to adequately clear infections in the hand.