Web space infection of the hand

This type of hand infection/abscess begins at the palmar aspect of the web space. Pus then passes over the distal edge of the deep transverse metacarpal ligament to enter the dorsal aspect of the web space. The abscess is now dumbbell shaped and resembles dress shirt buttons from the 19^th century, hence the name "collar button/shirt stud (en bouton de chemise) abscess." Although most of the pus is palmar, the abscess usually points dorsal.