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.

Related terms

• Condition

  Dupuytren's disease

  Benign progressive fibroproliferative disorder of the palmar and digital fascia, classified by WHO 2020 as a palmar-type fibromatosis. Characterised by myofibroblast-driven formation of nodules and cords in the palmar aponeurosis, leading to progressive flexion contracture of the digits, most commonly the ring and little fingers.

• Anatomy

  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.

• 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.

Articles mentioning this term

1. Patient information · 5 May 2026

   Dupuytren's disease

   A plain-language guide to Dupuytren's disease — what it is, what causes it, how it is diagnosed, and the contemporary treatment options including needle fasciotomy and limited fasciectomy. Written for patients by a consultant hand surgeon.

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