- 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;
