Key points

• Shape: triangular, fan-shaped fibrous sheet in the palm
• Proximal attachment (apex): continuous with palmaris longus tendon (if absent, anchored to the flexor retinaculum)
• Distal extension (base): sends longitudinal digital slips toward mainly the index, middle, ring, and little fingers
• Fiber types:
  • longitudinal fibers (dominant)
  • transverse fibers connecting longitudinal bundles
• Relations:
  • superficial to deeper palmar structures
  • deep to it lie digital vessels, nerves, and long flexor tendons
  • distally connected to skin via fibrous septa, helping skin fixation and grip

Functions

• Protects deeper palmar neurovascular and tendon structures
• Helps maintain palmar architecture and compartmentalization
• Assists grip mechanics by stabilizing palmar skin and fascia
• Kept tense partly by palmaris longus and palmaris brevis actions

Clinical relevance

• Dupuytren contracture: progressive fibrotic thickening/shortening of palmar fascia (aponeurosis), often affecting ring and little fingers, causing fixed flexion deformity and reduced hand function.