Smarter Decisions,
Better Care

UpToDate synthesizes the most recent medical information into evidence-based practical recommendations clinicians trust to make the right point-of-care decisions.

  • Rigorous editorial process: Evidence-based treatment recommendations
  • World-Renowned physician authors: over 5,100 physician authors and editors around the globe
  • Innovative technology: integrates into the workflow; access from EMRs

Choose from the list below to learn more about subscriptions for a:

Subscribers log in here

Finger and thumb anatomy


Injuries to the fingers and thumb are a common reason for visits to primary care clinics and emergency departments. To care for such injuries well, clinicians must have a sound grasp of basic hand anatomy.

The basic clinically relevant anatomy of the fingers and thumb is reviewed here. Specific finger injuries and their management are discussed elsewhere. (See "Extensor tendon injury of the distal interphalangeal joint (mallet finger)" and "Flexor tendon injury of the distal interphalangeal joint (jersey finger)".)


Finger function involves a complex interaction among multiple joints, flexor and extensor tendons, and supporting fascia and ligaments [1-6]. Each of the digits, except the thumb, has three phalanges with three hinged joints: distal interphalangeal (DIP), proximal interphalangeal (PIP), and metacarpophalangeal (MCP) (figure 1). Joint stability is provided by the structure of the phalanges, joint capsule, radial and ulnar collateral ligaments and dorsal and palmar ligaments.

Flexion and extension are the primary movements of the fingers. Abduction and adduction can be performed at the MCP joints. The thumb is capable of opposition, abduction, adduction, and retropulsion, in addition to flexion and extension. The thumb is discussed below. (See 'Thumb anatomy' below.) Tables and diagrams summarizing the movements and innervation of the fingers and thumb are provided (figure 2 and figure 3 and figure 4 and table 1 and table 2 and table 3).

Fingers are referred to by naming and numbering systems, but names appear to cause less confusion among clinicians [7]. Throughout the UpToDate reviews dealing with fingers and hands, we use standard names to refer to fingers (ie, thumb, index, middle, ring, and little). It is important to note that while the anatomy described below is considered standard, considerable variation exists among individuals.


Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2014. | This topic last updated: Sep 3, 2013.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2014 UpToDate, Inc.