Grayson ligaments are volar cutaneous ligaments of the fingers, arising from the fibrous flexor sheath and running volarly to anchor the volar lateral finger skin. They pass volar to the neurovascular bundle and maintain the volar skin position during finger extension. Grayson ligaments are involved in Dupuytren disease, contributing to spiral cord formation that displaces the neurovascular bundle medially and superficially.
Anchor the volar lateral finger skin to the fibrous flexor sheath, preventing skin displacement during finger extension.
Grayson ligaments are the critical source of spiral cord formation in Dupuytren disease. The diseased Grayson ligament, combined with diseased pretendinous band, spiral band, and natatory ligament, forms the spiral cord that displaces the neurovascular bundle medially and proximally, placing it at high risk during fasciectomy. Failure to recognise the spiral cord anatomy leads to digital nerve or artery division. The neurovascular bundle in a Dupuytren hand should always be identified proximally in normal tissue before dissecting the cord.
The Grayson ligament component of the Dupuytren spiral cord displaces the digital neurovascular bundle centrally and superficially in the finger, making it vulnerable to injury during fasciectomy; the spiral cord anatomy dictates that the neurovascular bundle is always identified in proximal normal tissue before approaching the diseased cord distally.
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