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Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit

Dupuytren’s disease is a benign fibroproliferative disorder resulting in progressive contraction of palmar and digital fascia. Diseased fascia of the hand condenses into tensile cords, manifesting in various anatomical combinations. The spiral cord variant is especially troublesome, as the cord trav...

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Autores principales: Kator, Jamie, Gopinath, Rohan, Miller, Nathan, Pensy, Raymond
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647618/
https://www.ncbi.nlm.nih.gov/pubmed/33173707
http://dx.doi.org/10.1097/GOX.0000000000003212
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author Kator, Jamie
Gopinath, Rohan
Miller, Nathan
Pensy, Raymond
author_facet Kator, Jamie
Gopinath, Rohan
Miller, Nathan
Pensy, Raymond
author_sort Kator, Jamie
collection PubMed
description Dupuytren’s disease is a benign fibroproliferative disorder resulting in progressive contraction of palmar and digital fascia. Diseased fascia of the hand condenses into tensile cords, manifesting in various anatomical combinations. The spiral cord variant is especially troublesome, as the cord travels under the digital neurovascular bundle and places it at risk during surgical resection. In severe cases, limited fasciectomy is required to release contracture and restore finger extension. Here, we present the case of a 79-year-old right-handed man with a history of severe Dupuytren’s disease of both hands, who was found to have ulnar and radial spiral cords in his right ring finger. Diseased tissue was removed en bloc, restoring extension and function. To our knowledge, this is the first case of a digit with two spiral cords affecting both neurovascular bundles. It is important to be aware of the anatomical variations possible in Dupuytren’s disease to avoid iatrogenic injury.
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spelling pubmed-76476182020-11-09 Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit Kator, Jamie Gopinath, Rohan Miller, Nathan Pensy, Raymond Plast Reconstr Surg Glob Open Hand/Peripheral Nerve Dupuytren’s disease is a benign fibroproliferative disorder resulting in progressive contraction of palmar and digital fascia. Diseased fascia of the hand condenses into tensile cords, manifesting in various anatomical combinations. The spiral cord variant is especially troublesome, as the cord travels under the digital neurovascular bundle and places it at risk during surgical resection. In severe cases, limited fasciectomy is required to release contracture and restore finger extension. Here, we present the case of a 79-year-old right-handed man with a history of severe Dupuytren’s disease of both hands, who was found to have ulnar and radial spiral cords in his right ring finger. Diseased tissue was removed en bloc, restoring extension and function. To our knowledge, this is the first case of a digit with two spiral cords affecting both neurovascular bundles. It is important to be aware of the anatomical variations possible in Dupuytren’s disease to avoid iatrogenic injury. Lippincott Williams & Wilkins 2020-10-28 /pmc/articles/PMC7647618/ /pubmed/33173707 http://dx.doi.org/10.1097/GOX.0000000000003212 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Hand/Peripheral Nerve
Kator, Jamie
Gopinath, Rohan
Miller, Nathan
Pensy, Raymond
Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit
title Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit
title_full Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit
title_fullStr Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit
title_full_unstemmed Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit
title_short Double Spiral Dupuytren’s Disease: Case of Ulnar and Radial Spiral Cords in Shared Digit
title_sort double spiral dupuytren’s disease: case of ulnar and radial spiral cords in shared digit
topic Hand/Peripheral Nerve
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647618/
https://www.ncbi.nlm.nih.gov/pubmed/33173707
http://dx.doi.org/10.1097/GOX.0000000000003212
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