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Pretendinous cord with nodules proximal and distal to the transverse fibres of the palmar aponeurosis. The pretendinous cord extends in the proximal phalanx and is responsible for a slight extension deficit of the proximal interphalangeal joint. There is also a pretendinous cord for the fourth finger in the palm. |
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Small curved incisions are staged along the bands. They are centred on the nodules. |
| The small skin flaps are elevated. Since there is no dissection plane between the dermis and the diseased fascia, one has to be created by sharp dissection. Without wide dissection, small segments of the fascia are excised while maintaining a constant traction on the cord. |  |
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The small bridges of fascia between the resected segments are left in place |
| The staged excisions are usually sufficient to obtain a full reextension at the end of the operation |  |
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45 years old man suffering from Dupuytren's disease since 10 years. The fourth and fith rays are affected in the palm and on the proximal phalanx. Severe skin invasion. |
| Two months after segmental aponeurectomy, there are still some signs of dystrophy and the remnants of the palmar cord are clearly visible. |  |
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One year after operation, the skin is perfectly supple, the cord has completely disappeared and the patient has regained full extension. |
| Three years after operation, there are no signs of recurrence and the scars are barely visible |  |