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J Hand Microsurg 2018; 10(01): 054-056
DOI: 10.1055/s-0037-1607047
Ideas and Innovations
Thieme Medical and Scientific Publishers Private Ltd.

“The Serpentine Zone”: A Surgeon's Guide to the Surface Anatomy of the Digital Neurovascular Spiral in Dupuytren's Contracture

Alistair R. M. Macey
1   Department of Trauma and Orthopaedics, NHS Dumfries and Galloway, Dumfries and Galloway Royal Infirmary, Dumfries, Scotland
,
Roshin Thomas
1   Department of Trauma and Orthopaedics, NHS Dumfries and Galloway, Dumfries and Galloway Royal Infirmary, Dumfries, Scotland
› Author Affiliations
Further Information

Publication History

Received: 03 July 2017

Accepted: 08 August 2017

Publication Date:
27 November 2017 (online)

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Abstract

The anatomy of the cords that form in Dupuytren's disease is complicated and a spiral cord is the most challenging variant to address. It displaces the neurovascular bundle toward or beyond the midline and closer to the skin. This article illustrates the surface anatomy of the neurovascular spiral to help surgeons identify this zone of danger that the authors term “the serpentine zone.” Careful dissection in this zone will help avoid iatrogenic digital neurovascular injury.

Keywords

Dupuytren's - spiral cords - surface anatomy
 

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