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.
Transmit palmaris longus tension to the digits; form the pretendinous bands that thicken into Dupuytren's cords
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.
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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