Wrist is also known as carpus. There are eight carpal bones arranged in proximal and distal rows, presenting gentle concavity on the anterior side. All the four fingers lie in one plane while the thumb is isolated from the fingers and has undergone rotation of 90 degrees. A larger elevation on the lateral side of the palm is known as thenar eminence, which is more prominent than its counterpart on the medial side the hypothenar eminence. Muscles of the thenar eminence are supplied by the median nerve and the muscles of the hypothenar eminence are supplied by the ulnar nerve. The veins of the hand are present on the dorsum on the hand, obviously due to the fact that the surface is not subjected to the pressure and the lax character of the skin of the dorsum allows free dilatation of the veins. It is important to remember that all lymphatics of the hand crowd on the dorsum of the hand hence, infection of the hand presents with oedema on the dorsum of the hand and not on the palmar. Palmar aponeurosis is a triangular fibrous expansion of the tenden of palmaris longus situated in the middle of the hand. Median nerve passes through the carpal tunnel along with the tendons and their synovial sheaths. In case of the inflammation of the synovial sheath, the pressure inside the carpal tunnel increases giving rise to the pain along with the distribution of the median nerve. Carpometacarpal joint of the thumb is synovial saddle shaped joint between the concavoconvex base of the first metacarpal and the reciprocal articular surface of the trapezium. The thumb is capable of getting flexed, extended, adducted, abducted and can perform opponens. Adductor pollicis muscle lies at the deeper level almost in front of the metacarpal bones and the interossei. It has two heads namely the transverse and the oblique. The muscle is enclosed in a fascial space known as the adductor space. Adductor pollicis muscle is supplied by the deep branch of the ulnar. Superficial palmar arch is an arched continuation of an ulnar artery in the palm which is completed by the superficial branch of radial artery on the lateral side. Deep palmar arch is formed by the continuation of the radial artery in the palm and is completed by the deep branch of the ulnar artery on the medial side. Deep palmar arch lies infront of the metacarpal bones and is finger’s breadth proximal to the superficial palmar arch. There is four lumbrical muscles numbered as 1,2,3,4 from lateral to medial side. Each of them arises from the radial side of the flexor digitorum profundus tendon of the respective side. By virture of their insertion into extensor expansion, lumbrical interossei are flexors of the metacarpo-phalangeal joints and extensors of inter-phalangeal joints. There are eight interossei, four palmar and four dorsal. All the interossei are supplied by the deep branch of the ulnar nerve. Palmar interossei are adductors while the dorsal interossei are the abductors. Palmar interossei are uniheaded and the dorsal interossei are double headed. Ulnar nerve in the hand divides at the distal border of the flexor of the retinaculum into the superficial and the deep branches. Superficial branch supplies palmaris brevis and gives cutaneous innervations to the medial one and half finger. The deep branch supplies the muscles of the hypo-thenar eminence, four palmar and the four dorsal interossei, medial two lumbricals, wrist joints and the adductor pollicis muscle. It may be mentioned here that the deep branch of the medial nerve is called musician’s nerve. Median nerve after its emergence from the carpal tunnel presents an enlargement and divides into medial and lateral branches. Lateral branch supplies the muscles of the thenar eminence and gives three digital branches, while the medial division divides into two palmar digital branches. Lateral two lumbricals are in the palm supplied by the median nerve. Common synovial sheath is interrupted in the middle of the palm; as a result tendons of the index, middle and the ring finger are devoid of synovial sheaths. Due to continuity with the radial and the ulnar bursae, the synovial sheaths of the thumb and the little finger are in communication with radial and the ulnar bursae, hence there is a tendency of spread of infection from the tip of the thumb and the tip of the little finger. There are palmar spaces in the hand which are of surgical importance. They are thenar space, mid-palmar space, four lumbrical spaces, adductor space, pulp space, web spaces and the dorsal space. As the pulp space lies infront of the terminal phalanx separated from the fibrous flexor sheath, the pulp space infection can not be the source of flexor tendon sheath infections.