Digital neurovascular bundle

Bundle containing the proper digital artery, proper digital nerve, and accompanying veins, running along the radial and ulnar aspects of each finger, deep to Grayson's ligament and superficial to Cleland's ligament. Its position is normally predictable but is displaced by the spiral cord in Dupuytren's disease.

Related terms

• Anatomy

  Spiral cord

  Pathological cord formed by the confluence of the pretendinous band, spiral band, lateral digital sheet, and Grayson's ligament. Displaces the digital neurovascular bundle palmarly, centrally toward the digital midline, and proximally — most marked at the level of the proximal phalanx. The principal anatomical reason needle fasciotomy is contraindicated for established proximal interphalangeal contracture.

• Anatomy

  Palmar aponeurosis

  Triangular sheet of dense connective tissue overlying the long flexor tendons in the palm, with longitudinal, transverse, and vertical fibre bundles. The longitudinal fibres condense into the pretendinous bands. The aponeurosis becomes the source tissue for cord formation in Dupuytren's disease.

• Procedure

  Percutaneous needle fasciotomy

  Office-based percutaneous division of the Dupuytren cord with a small-bore (typically 25-gauge) needle under skin-wheal local anaesthesia, indicated for palpable pretendinous-cord contracture in selected primary disease. Reintroduced in the late 1970s by the French rheumatologist Lermusiaux. Shorter recovery and higher recurrence than limited fasciectomy.

• Procedure

  Limited fasciectomy

  Open surgical excision of the diseased palmar and digital fascia through a Bruner-zigzag or longitudinal-Z-plasty incision, with preservation of normal fibres. The contemporary operative workhorse for Dupuytren's contracture. Lower five-year recurrence than percutaneous needle fasciotomy at the cost of greater up-front morbidity, longer recovery, and a higher rate of nerve and vessel injury.

Articles mentioning this term

1. Patient information · 5 May 2026

   Choroba Dupuytrena (przykurcz Dupuytrena)

   Choroba Dupuytrena jest łagodnym, postępującym schorzeniem rozcięgna dłoniowego, prowadzącym do utrwalonego zgięcia palców. Niniejszy artykuł wyjaśnia, jak choroba przebiega, kiedy potrzebne jest leczenie i czego można spodziewać się po zabiegu.

2. Expert blog · 5 May 2026

   Choroba Dupuytrena — leczenie operacyjne

   Aponeurotomia igłowa i fasciektomia ograniczona w pierwotnym leczeniu choroby Dupuytrena — przegląd dowodów, anatomia patologiczna pasm jako predyktor wyboru techniki, definicja nawrotu, polski kontekst refundacyjny.

3. FESSH preparation · 5 May 2026

   Dupuytren's disease

   An expert synthesis of Dupuytren's disease — anatomy, the McFarlane cord pattern, the contemporary treatment landscape after the European withdrawal of collagenase, and the parallel consensus definitions of recurrence — for FESSH candidates and consultant peers.

← Back to glossary