Pre-Tendinous Cord



- Discussion:
    - arises from thickening and contracture of pretendinous bands:
    - inserts into skin distal to MP joint & into tendon sheath does not cause N/V displacement, but is responsible for MP
           flexion deformities which can be predictably corrected by surgical excision;
    - at a point just distal to the superficial transverse palmar ligament (which is just proximal to the metacarpal heads), the 
         pretendinous cord bifurcates to form the spiral bands;

- Surgical Excision:
    - transverse incision is made across exposed offending pre-tendinous is released into extension;
    - N/V bundle is well protected at this level, lying dorsal to palmar fascia;
          - skin fixation to palmar & digital fascia & nodules makes dissection in distal part of palm, esp in digit, hazardous, for NV bundle may lie
                  either superficial or deep to the diseased fascia;
          - in little finger, ulnar palmar digital nerve should be isolated proximally over muscle belly of the abductor digiti quinti and progressively 
                  dissected free from the diseased fascia



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, September 12, 2011 2:33 pm