Cleland ligaments are dorsal cutaneous ligaments of the fingers, arising from the phalanges and running dorsally to anchor the lateral skin of the digit. They run dorsal to the neurovascular bundle and maintain the skin position on the finger during flexion. Unlike the volar Grayson ligaments, Cleland ligaments are not involved in Dupuytren disease contracture cords and can be preserved during fasciectomy.
Anchor the dorsal lateral finger skin to the phalanges, preventing the skin from sliding volarly during finger flexion.
The clinical significance of Cleland ligaments lies primarily in their differentiation from Grayson ligaments in Dupuytren fasciectomy. Understanding that Cleland ligaments are dorsal to the neurovascular bundle (while Grayson ligaments are volar) guides safe dissection in Dupuytren surgery: identifying the neurovascular bundle between the two ligament layers allows safe skeletonisation of the cord while preserving the digital vessels and nerves. Cleland ligaments may be inadvertently divided during ring avulsion injury management.
Safe Dupuytren fasciectomy requires understanding that Cleland ligaments run dorsal to the digital neurovascular bundle while Grayson ligaments run volar; the diseased cord lies between these fascial layers, and correct tissue plane identification protects the digital nerve and artery from injury during cord excision.
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