Abstract
In order to understand the pathogenesis and symptomatology of Dupuytren's contracture it is essential to have a thorough acquaintance with the anatomy of the palmar aponeurosis. Such knowledge is also indispensable to the performance of suitable surgical treatment of afflicted hands. Since Dupuytren (1832) demonstrated that changes localized to the aponeurosis are the cause of this deformity there has been a marked interest in the fascial framework of the palm, and the cure obtained by removal of the palmar aponeurosis still justifies an interest in the aponeurosis per se. The purpose of this paper is to report on some original observations on the arrangement of the transverse palmar ligament, and the behaviour of the transverse elements of the palmar aponeurosis in Dupuytren's contracture. From these findings conclusions are made with regard to the pathogenesis of the disease and a technique for selective aponeurosectomy is recommended for the surgical treatment of contracted hands.
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