Observations on contraction of the fingers (Dupuytren's contraction) : and its successful treatment by subcutaneous divisions of the palmar fascia, and immediate extension also on the obliteration of depressed cicatrices after glandular abcesses, or exfoliation of bone by a subcutaneous operation / by William Adams.

  • Adams, William, 1810-1900.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Observations on contraction of the fingers (Dupuytren's contraction) : and its successful treatment by subcutaneous divisions of the palmar fascia, and immediate extension also on the obliteration of depressed cicatrices after glandular abcesses, or exfoliation of bone by a subcutaneous operation / by William Adams. Source: Wellcome Collection.

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    performed. It will also be observed that in many persons, especially tliose less accustomed to manual labour, the flexion-furrow of the index finger curves upwards towards the central part of the palm of the hand, whilst the flexion-furrow belonging to the three outer fiugers curves downwards towards the cutaneous webb between the index and middle fingers; the deviation from the continuous transverse line is no doubt due to the more independent habitual flexion of the index finger. The main point, however, in reference to our present subject, is that this transverse crease, or flexion-furrow precisely corresponds to the meta- carpo-phalangeal articulations, and that if a needle were entered at this transverse furrow on the palmar aspect, it would, in transfixing the hand, pass through the metacarpo-phalaugeal articulation. Now, we know, as an anatomical fact, that the flexor tendons of the fingers enter their dense tubular sheath on the palmar aspect of the first phalanx, just at the margin of the metacarpo-phalaugeal articula- tion, as well shown in Fig. 4, h and c, from prepara- tion in St. Bartholomew's Hospital Museum, and continue their course along the finger in close proximity with the bone, so that a needle trans- fixing the hand from the transverse flexion-furrow in the palm, very closely indicates the spot at which the flexor tendons enter their dense tubular sheath. From this dense tubular sheath no anatomist would believe the flexor tendons could be dislodged by any traction-power exerted by contraction of the palmar fascia, yet the spot at which the tendons enter the sheath also corresponds to the most prominent part