The Hip book
Home » Bones » Hand » Spiral Bands / Cords

Spiral Bands / Cords

- Discussion:
    - spiral band is continuation of pretendinous cord;
           - at a point just distal to the superficial transverse palmar ligament (which is just proximal to the metacarpal heads), the pretendinous cord bifurcates to form the spiral bands;
    - spiral band passes deep to the N/V bundle and then forms a coalescence with the natatory liagment;
           - proximally the spiral bands dives deeply into palm, and twist 90 deg as they pass across the metacarpal head and ends up lying in the saggital plane;
    - spiral band winds around the N/V bundle to reach lateral digital sheet (thickening of superficial fascia on side of finger);
           - lateral digital sheet receives fibers from natatory ligament & spiral band;
           - more distally, the lateral digital sheet passes distally along the side of the digit, lying lateral to the neurovascular bundle;

- Surgical Considerations:
    - when resection Dupuytren's contracture, the neurovascular bundles are especially at risk ath the level of the MP joint;
           - spiral cords are most responsible for distorted position of N/V bundle;
           - the spiral cords may pull the N/V bundle in a superficial and central direction, making them vulnerable during the dissection;
           - unlike the palm, there may be no overlying fascial cover