Pulp spaces of hand

The pulp spaces are on the palmar side of the tips of the fingers and thumb. They contain fatty tissue that is divided into numerous compartments by fibrous septa that pass between the distal phalanx and the skin. Terminal branches of the digital vessels course through the spaces and some of them supply the end of the distal phalanx (but not the epiphysis); infection of the pulp spaces may occlude these vessels and cause necrosis of the end of the bone. The pulp space is limited proxi­mally by the firm adherence of the skin of the distal flexion crease to the underlying tissue; this prevents pulp infection from spreading proximally along the finger.