Dupuytren Disease-SPIRALLING OF THE NEUROVASCULARBUNDLE IN DUPUYTREN’S DISEASE

SPIRALLING OF THE NEUROVASCULARBUNDLE IN DUPUYTREN’S DISEASE

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Dupuytren's disease is a condition characterized by the formation of abnormal cords of tissue in the hand, which can cause the fingers to contract and become immobile. In some cases, these cords can cause displacement of the neurovascular bundle, which is a structure that contains nerves and blood vessels that supply the hand. This can occur when cords connect tissue above the neurovascular bundle to tissue below it. <br /><br />In this study, the authors describe six cases in which cord formation and contraction resulted in a distal spiral of the neurovascular bundle. This can happen in isolation or in combination with a classical proximal spiral, resulting in a double spiral or corkscrew neurovascular bundle. The authors explain that the abnormal and superficial position of the neurovascular bundle in these cases puts it at risk of injury during surgery. <br /><br />The authors also discuss the anatomy of the palmar and digital fascia and how it is involved in the development of Dupuytren's disease. They explain that the disease transforms normal fascial bands into pathological cords, and these cords can connect fascia that is superficial to the neurovascular bundles with fascia that is deep to them. This connection can cause displacement of the neurovascular bundles and lead to the formation of spiraling cords.<br /><br />The authors conclude by stating that the presence of a spiral cord can be identified by the presence of mobile skin over a cord, a joint contracture, or a palpable cord connecting superficial and deep fascia. Surgeons performing surgery for Dupuytren's disease should be aware of the variations in the pathological anatomy and take precautions to prevent injury to the neurovascular bundle.

Keywords

Dupuytren's disease

abnormal cords

hand

fingers

neurovascular bundle

cord formation

anatomy of fascia

pathological cords

spiral cord

injury prevention