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Palmar aponeurosis

Aponeurosis palmaris

The tough triangular sheet lying directly beneath the skin in the middle of the palm, its point at the wrist and its base fanning into four slips that run out to the bases of the fingers. It is bound tightly to the skin above and to the fibrous finger sheaths below, which is why palm skin grips rather than slides when you hold something, unlike the loose skin on the back of the hand. Beneath it lie the long flexor tendons, the superficial palmar arch and the common digital nerves, so the sheet is also their shield. It is the tissue involved in Dupuytren's contracture, where thickened cords within the aponeurosis draw the fingers towards the palm.