The palm of the hand constitutes the area located on the internal face of the hand and notably allows gripping.

Position. The palm of the hand is located on the inside of the hand, between the wrist and the fingers (1).

Bone structure. The palm of the hand is made up of the pastern, made up of five long bones that are placed in the extension of each finger (2).

Tissue structure. The palm of the hand is made up (1):

• ligaments;
• of the intrinsic muscles of the hand, which are the thenar and hypothenar eminences, the lumbricals, the interossei, as well as the adductor muscle of the thumb;
• tendons from the muscles of the anterior compartment of the forearm;
• of the palmar aponeurosis.

Envelope. The palm of the hand is covered by a thick surface of skin. The latter is hairless and contains many sweat glands. It is also marked by three deep wrinkles called the “palmar flexion folds”.

Innervation and vascularization. The palm of the hand is innervated by the median and ulnar nerves (3). Blood supply is provided by the radial and ulnar arteries.

Information role. The palm of the hand has a strong sensitivity which allows to obtain a lot of external information (4).

Execution role. The palm of the hand allows the grip, which constitutes the set of functions allowing the grip (4).

Other roles. The palm of the hand is also used in expression or feeding (4).

Different problems can arise in the palm of the hand. Their causes are varied and can be of bone, nervous, muscular or even articular origin.

Bone pathologies. The skeleton of the palm of the hand can suffer fractures but can also suffer from certain bone conditions. For example, osteoporosis is a loss of bone density that is typically found in people over the age of 60. It accentuates bone fragility and also promotes bills (5).

Nerve pathologies. Various nerve pathologies can affect the palm of the hand, for example carpal tunnel syndrome refers to disorders associated with compression of the median nerve at the level of the carpal tunnel, more precisely at the level of the wrist. It manifests as tingling in the fingers and loss of muscle strength, especially in the palm (6).

Muscular and tendon pathologies. The palm can be affected by musculoskeletal disorders, recognized as occupational diseases and occurring during excessive, repetitive or sudden stress on a limb.

Joint pathologies. The palm of the hand can be the seat of joint conditions such as arthritis, grouping together the pains associated with the joints, ligaments, tendons or bones. Osteoarthritis is the most common form of arthritis and is characterized by the wear and tear of the cartilage protecting the bones in the joints. The palm joints can also be affected by inflammation in the case of rheumatoid arthritis (7).

Prevention of shock and pain in the palm of the hand. In order to limit fractures and musculoskeletal disorders, prevention by wearing protection or learning appropriate gestures is essential.

Symptomatic treatment. In order to reduce the discomfort, the subject can wear a splint during the night. This is recommended, for example, in the case of carpal tunnel syndrome.

Orthopedic treatment. Depending on the type of fracture, the installation of a plaster or a resin will be carried out to immobilize the palm.

Drug treatments. Depending on the pathology diagnosed, different treatments are prescribed to regulate or strengthen bone tissue. Certain medications may also be prescribed to help decompress a nerve.

Surgical treatment. Depending on the pathology diagnosed and its evolution, a surgical operation may be carried out.

Physical examination. First, a clinical examination is carried out in order to observe and assess the sensory and motor signs perceived by the patient in the palm of the hand.

Medical imaging examination. The clinical examination is often supplemented by an x-ray. In some cases, doctors will use an MRI or CT scan to assess and identify lesions. Scintigraphy or even bone densitometry can be used to assess bone pathologies.

Electrophysiological exploration. The electromyogram makes it possible to study the electrical activity of the nerves and to identify potential lesions.