Displacement of the neurovascular bundle within a digit affected by Dupuytren’s disease can occur when disease superficial to the neurovascular bundle is connected to disease deep to it. Contraction of such cords results in spiralling of the neurovascular bundle, classically when a pretendinous cord connects with the lateral digital sheet and Grayson’s ligament via the oblique cord, but also in association with an isolated digital cord. We describe six cases in which cord formation and contraction resulted in a distal spiral, which may occur in isolation or in combination with a classical proximal spiral, creating a double spiral or corkscrew neurovascular bundle.
BrunerJM. The dynamics of Dupuytren’s disease. Hand. 1970, 2: 172–7.
2.
GossetJ. Dupuytren’s disease and the anatomy of the palmodigital aponeuroses. In: In: HuestonJTTubianaR (Eds.) Dupuytren’s disease, 3rd Edn. Edinburgh, Churchill Livingstone, 1974: 11–23.
3.
HollandAJMcGroutherDA. Dupuytren’s disease and the relationship between the transverse and longitudinal fibers of the palmar fascia: a dissection study. Clin Anat. 1997, 10: 97–103.
4.
HuestonJT. Digital Wolfe grafts in recurrent Dupuytren’s contracture. Plast Reconstr Surg Transplant Bull. 1962, 29: 342–4.
5.
McFarlaneRM. Patterns of the diseased fascia in the fingers in Dupuytren’s contracture. Displacement of the neurovascular bundle. Plast Reconstr Surg. 1974, 54: 31–44.
6.
RayanGM. Palmar fascial complex anatomy and pathology in Dupuytren’s disease. Hand Clin. 1999, 15: 73–86.
7.
ShortWHWatsonHK. Prediction of the spiral nerve in Dupuytren’s contracture. J Hand Surg Am. 1982, 7: 84–6.
8.
StackHG. The palmar fascia and the development of deformities and displacements in Dupuytren’s disease. In: In: HuestonJTTubianaR (Eds.) Dupuytren’s disease, 3rd Edn. Edinburgh, Churchill Livingstone, 1974: 153–62.
9.
StricklandJWBassettRL. The isolated digital cord in Dupuytren’s contracture: anatomy and clinical significance. J Hand Surg Am. 1985, 10: 118–24.
10.
ThomineJM. The development and anatomy of the digital fascia. In: In: HuestonJTTubianaR (Eds.) Dupuytren’s disease, 3rd Edn. Edinburgh, Churchill Livingstone, 1974: 1–9.
11.
UmlasMEBischoffRJGelbermanRH. Predictors of neurovascular displacement in hands with Dupuytren’s contracture. J Hand Surg Br. 1994, 19: 664–6.
