The darn spiral nerve

This video is about an anatomical aberration in Dupuytren disease, the so-called spiral nerve. We have documented a case of our own. This patient was suffering from a flexion contracture of his right ring finger and was thought to be an ideal candidate for percutaneous needle fasciotomy (PNF). During the procedure he unexpectedly felt sudden pain, so that we stopped the manipulation. A few weeks later we performed a limited fasciectomy and could confirm that the suspected irregularity of the nerve was there.

In addition to footage from the OR there are beautiful illustrations drawn by Prof. Martin Langer, well-known hand surgeon from Münster, that help to understand the nature of this problem.

Further illustrations are from „Dupuytren’s Disease“ von Raoul Tubiana, Caroline Leclercq und Larry Hurst (https://www.amazon.de/Dupuytrens-Dise…)

References:

Therkelsen LH et al.: Percutaneous needle fasciotomy in Dupuytren contracture: a register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients. Acta Orthop 2020 Feb 14;1-5. doi: 10.1080/17453674.2020.1726057.

Alistair R. M. Macey, Roshin Thomas: “The Serpentine Zone”: A Surgeon’s Guide to the Surface Anatomy of the Digital Neurovascular Spiral in Dupuytren’s Contracture. Journal of Hand and Microsurgery. Vol. 10 No. 1/2018. DOI https://doi.org/ 10.1055/s-0037-1607047.

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