Abstract
Dear Sir,
Injury to the digital nerves is a recognised complication of surgery for Dupuytren's disease. We describe a sentinel sign to aid in the intraoperative identification of the digital nerves.
Clear silver Pacinian corpuscles are encountered and are visible during dissection of the subcutaneous fat as the digital nerve is approached. We have observed that the digital nerve lies directly deep to the plane of the Pacinian corpuscle. We have commonly seen them on the ulnar aspect of the hand, overlying the ring and little finger metacarpals although this may simply reflect the fact that Dupuytren's disease more commonly affects these areas. The Pacinian corpuscle is clearly visible to the naked eye (Fig 1). Identification of a Pacinian corpuscle therefore alerts the operating surgeon to the proximity of a digital nerve, thus reducing the risk of injury to digital nerves, particularly when they are close to cords of Dupuytren's tissue.