ARTERIES AND NERVES OF THE PALM - SURGICA L ANATOMY OF DUPUYTRENS-DISEASE

It has been reported that the skin of the palm is supplied by arteries receiving their blood from a radial, thenar, ulnar, or hypothenar art erial system. Interestingly, the middle of the palm has been described as hypovascularized, but detailed informations on number and distribu tion of blood vessels are not available. By surgical treatment of the Dupuytrens contracture we could show that preservation of the blood ve ssels and nerves supplying the skin leads to excellent postoperative r esults. However, our intraoperative observations do not correspond to the picture of a poorly vascularized region of skin in the middle of t he hand. During surgical treatment we found between six and nine bundl es consisting of one artery, at least one vene, and one nerve in each case. The bundles perforate the palmar aponeurosis through channels, a nd subaponeurotically a lot of them originate from further proximal th an expected. This information should be taken into consideration durin g the exstirpation of the palmar aponeurosis.