A 60-year-old man has progressive fixed flexion of the metacarpophalangeal joint of the ring finger with a palpable cord in the palm and positive tabletop test. Which structure forms the pathological cord responsible for the metacarpophalangeal contracture?
- A Pretendinous band of the palmar fascia ✓
- B Spiral band of the digital fascia
- C Natatory ligament
- D Transverse retinacular ligament
Correct answer: A. Pretendinous band of the palmar fascia
Explanation
In Dupuytren disease the pretendinous bands of the palmar fascia hypertrophy into cords that pull the metacarpophalangeal joint into flexion. The spiral band cord wraps around the neurovascular bundle and causes proximal interphalangeal contracture, while the natatory ligament produces web space adduction contracture. The transverse retinacular ligament relates to boutonniere deformity, not Dupuytren disease.
Reference: Green's Operative Hand Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.