What is the palmar fascia anyway?! скачать в хорошем качестве

What is the palmar fascia anyway?!

Dr Richard Shaffer from www.dupuytrensuk.com tells you everything you need to know about the palmar fascia as it relates to Dupuytren's disease of the hand. The palmar fascia is a sheet of thick fibrous connective tissue in the palm. It serves as a protective layer, provides structural support, and transmits force between the structures above and below it. It's a complex structure made up of several interconnected components. But for our purposes, the main relevance is how it's affected in Dupuytren's disease. Before we look at the individual parts of the palmar fascia, it's important to note the fascia itself is relatively thin—typically around 5 to 8 millimeters. This has practical implications for radiotherapy, as it guides how deep the treatment needs to penetrate to adequately treat early Dupuytren's disease. The most important part of the palmar fascia is the central aponeurosis, which is a fan-shaped structure that extends from the wrist to the base of the fingers. This is the structure most commonly involved in Dupuytren's disease, where progressive thickening and contracture can cause a reduction in finger extension. The thenar and hypothenar fasciae cover and support the corresponding muscles as well as the nerves and tendons in those areas. They tend to be spared in Dupuytren's disease. The natatory ligaments are found in the webspaces between the fingers and help prevent excessive finger spread. They can sometimes be involved with Dupuytren's disease, with thickening, hardness, or even nodules. This can reduce finger spread and change a normal U-shaped webspace into a narrowed V-shaped webspace. You can also get bands in the first webspace, where there's thickening or nodularity of the commissural ligaments. These can reduce thumb extension, which is only really a problem if you have specialized function—such as needing a full hand span as a pianist. You can see that the lateral digital sheets extend quite distally up the fingers. So if you get a Dupuytren's nodule on the side of the finger, then you would extend the treatment field more distally than normal.