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.

Related terms

• 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.

• 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.

• 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.

Articles mentioning this term

1. 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.

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