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Hand Abscess ˈab-ˌses

By David R. Steinberg, MD, Associate Professor, Department of Orthopaedic Surgery, and Director, Hand and Upper Extremity Fellowship, Perelman School of Medicine at the University of Pennsylvania

A hand abscess is an accumulation of pus affecting the hand, usually caused by a bacterial infection.

Abscesses in the hands are fairly common and usually result from injury. A shallow (superficial) abscess may develop just under the skin anywhere in the hand and nearly always results from a minor injury, such as a splinter or needle prick. Severe pain, warmth, and redness develop over the abscess, often with swelling of lymph nodes in the armpit. A deeper abscess may occur in any part of the palm and spread between the metacarpal bones (the hand bones between the wrist and fingers). Such an infection may occur after the skin is ripped or the hand is punctured by something sharp. Palm abscesses may develop from an infected callus. Palm abscesses begin as intense throbbing pain with swelling and severe tenderness when touched. The swelling and pain may be greater at the top of the hand than on the palm.

Doctors base the diagnosis of a hand abscess on an examination. They do x-rays to detect any foreign bodies (such as a tooth fragment, needle, or other object) that may be hidden under the skin.

Treatment

  • Drainage of pus

  • Antibiotics and a splint

Treatment of a hand abscess involves surgically draining the pus through an incision. Antibiotics also are given, and people wear a splint until the infection goes away.

People may need to undergo physical therapy afterwards to overcome stiffness and swelling and improve function.

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