DUPUYTRENS DISEASE AND THE RELATIONSHIP BETWEEN THE TRANSVERSE AND LONGITUDINAL FIBERS OF THE PALMAR FASCIA - A DISSECTION STUDY

Dupuytren's disease is characterized clinically by a proliferative fib rous contracture of the palmar or digital fascia. A logical approach t o the assessment and treatment of this complex condition requires a pr ecise knowledge of the anatomy of the palmar fascia. This dissection s tudy was carried out on ten cadaveric hands to determine the relations hip between the longitudinal and transverse fibers of the palmar fasci a. We found that the deepest layer of the three longitudinal layers of the palmar fascia (layer 3) divided at the transverse fibers into two sub-layers. Fibers of the deeper sub-layer passed dorsally, proximal to the transverse fibers of the palmar fascia, whereas the more superf icial fibers of layer 3 passed dorsally distal to the transverse fiber s. The literature is reviewed and the significance of these findings i s discussed in relation to the surgical treatment of Dupuytren's disea se. (C) 1997 Wiley-Liss, Inc.