Palmar Aponeurosis Longitudinal Bands

fasciculi longitudinales aponeurosis palmaris

The palmar aponeurosis longitudinal bands are the fibrous cords running from the flexor retinaculum to the fingers, providing the palm's structural framework. In Dupuytren's disease, these pretendinous bands thicken and contract into Dupuytren's cords (natatory, pretendinous, and lateral digital cords), producing progressive finger flexion contractures. The ring and little fingers are most commonly affected.

Anatomical Data

Boundaries & Contents

Location	Palm of the hand, beneath the skin and fat
Boundaries	Apex: continuous with the flexor retinaculum and the palmaris longus tendon Distally: four pretendinous bands to the fingers, attached to the fibrous flexor sheaths, deep transverse metacarpal ligaments and skin Superficial transverse (natatory) fibres near the finger webs Vertical septa pass to the metacarpals
Contents	Superficial palmar arch Common palmar digital nerves and vessels Long flexor tendons

Biomechanics

Function & Actions

Protects the vessels, nerves and tendons in the palm and anchors the palmar skin for grip. Its bands become the diseased cords in Dupuytren disease.

Clinical Relevance

Clinical Notes

Dupuytren's disease produces progressive palmar nodules, pitting, and cords that draw the fingers into flexion contracture. Fasciectomy (excision of the Dupuytren's cord) is indicated when the MCP contracture exceeds 30 degrees or any PIP contracture is present. Collagenase (Xiaflex) injection enzymatically dissolves the cord, effective for pretendinous cords but higher recurrence than fasciectomy.

Pathology

Common Injuries & Conditions

Dupuytren's Contracture

Palmar aponeurosis cord thickening producing finger flexion contracture managed with collagenase injection for MCP contractures or fasciectomy for combined MCP-PIP contractures.

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