- Discussion:
- typically involves palmar aponeurosis and digital prolongation (not superficial
transverse ligament) in palm;
- involves lateral digital sheet,
Grayson's lig (not
Cleland's lig),
pretendinous bands,
natatory ligament, & spiral bands in digits;
- typically digits develop central (pretendinous) &
spiral cords;
- pre-tedinous bands
- central cord:
- has no normal fascial precursor;
- is a continuation of
pretendinous cord & lies
between the neurovascular bundles;
- it courses over the middle of the proximal phalanx and attaches distally
to bone & tendon sheath over the middle phalanx;
- nodules may be found at the level of the
PIP Joint;
- pip joint involvement:
- natatory ligament (superficial palmar transverse ligament)
- crosses the palm just proximal to the distal palmar crease;
- does not produce contractures of the digits, although it may contribute
to thumb-index web-space contracture;
- spiral band
- retrovascular cord:
- alone does not often cause
PIP Joint contracture;
- it is a cause of recurrent contracture, & w/ lateral cord, it
contributes to DIP contracture;
- lateral cord (digital sheet):
- arises from superficial fascia that surrounds the finger in saggital plane;
- lateral cord lies lateral to N/V bundle;
- diseased fibers do not pass dorsally but extend distally and may also
cause contracture at the DIP joint;
- Grayson's ligament
