Arthroscopic Palmar Membrane Release for Dupuytren’s Disease

Abstract

The main function of the palmar aponeurosis is to increase grip of the hand. The central portion of palmar aponeurosis occupies the middle of the palm, triangular in shape (Fig. 5.1). Dupuytren’s contracture or Dupuytren’s disease (DD) is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. The ring finger and little finger are the fingers most commonly affected. The middle finger may be affected in advanced cases, but the index finger and the thumb are nearly always spared [1]. The disease is common in men older than 40 years; in persons of Northern European descent; and in persons who smoke, use alcohol, or have diabetes [2]. A review and meta-analysis results support the hypothesis of an association between high levels of work exposure (manual work and vibration exposure) and Dupuytren’s contracture in certain cases [3].