New findings on intermetacarpal fat pads: anatomy and imaging

Many studies have focused on the functional importance of the gliding structures of the hand. These structures are clinically important in reconstructive surgery and mechanically essential for an efficient hand grasp. The aims of this study were to first review the intermetacarpal space and then focus on its fatty tissue, the intermetacarpal fat pad. This study used dissections and histological analysis of fetal and adult hands and CT scans of adult hands. The intermetacarpal fat pads are well-defined adipose structures located between the heads of the second, third, fourth and fifth metacarpal bones. They are located in spaces defined by the palmar fascia and its deep expansions. These spaces are closed distally but open proximally into the tunnels surrounding the flexor tendons (Legueu and Juvara canals). The pads are composed of non-mobilizable fat; they protect the neurovascular pedicles of the fingers. They may act with the palmar skin to mitigate compressive and shear forces during gripping. Finally they may be involved in neurological symptoms if their size is increased by any trauma or inflammatory process.