A 58-year-old man has progressive flexion contracture of the ring finger metacarpophalangeal joint, with a palpable cord in the palm. Histology of the resected tissue shows proliferation of myofibroblasts. The cord responsible for isolated metacarpophalangeal joint contracture arises from which normal structure?
- A Spiral band
- B Natatory ligament
- C Pretendinous band ✓
- D Transverse retinacular ligament
Correct answer: C. Pretendinous band
Explanation
Dupuytren disease involves proliferation of myofibroblasts within the palmar fascia. The pretendinous band becomes a cord that pulls the metacarpophalangeal joint into flexion. The spiral band cord, formed from the pretendinous band plus spiral, lateral and transverse fibres, wraps around the neurovascular bundle and chiefly causes proximal interphalangeal contracture. The natatory ligament produces web-space adduction contractures, and the transverse retinacular ligament relates to the finger, not the palm.
Reference: Green's Operative Hand Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.