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Dupuytren’s Disease (or Contracture)

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Dupuytren’s Disease is a deformity in the hand that can change its appearance and may cause difficulty in using your fingers. It causes a layer of tissue under the skin of your palm to form knots of tissue, which then forms into a thick strand that pulls your fingers in towards the palm. This disease develops slowly, and most commonly affects the pinky and ring finger. The fingers that are affected by Dupuytren’s cannot be completely straightened, which can be a complication in everyday tasks such as simply placing your hands in your pockets.

There is no known cause of Dupuytren’s Contracture, although there is a high chance that it can be inherited in a family. Some doctor’s claim that activities such as alcohol consumption and smoking may contribute to the tissue formations.

Dupuytrens Disease

Dupuytrens Disease

Symptoms

Some symptoms of Dupuytren’s Disease include:

  • Small lump in the palm of the hand
  • Dupuytren’s contracture (fibrous cord in the tissue that pulls a finger toward the palm)
  • Can’t fully straighten fingers, or flatten hands
  • Usually no pain involved
  • Picking up objects may be difficult

Risks

Gender – Men have a higher likelihood than females to contract Dupuytren’s Disease, and typically
have a more severe case as well

Age – Dupuytren’s is most common in individuals past the age of 50

Family History – Known to be passed down/inherited

Diabetes – Having diabetes increased the risk of being diagnosed with Dupuytren’s

Smoking, Alcohol – Smoking may trigger changes within blood vessels

Diagnosis

When you visit the doctor, they will examine your palm for any skin changes and physical feel the different parts of the palm and fingers for any tight cords, or knots. They may ask you to move your fingers around, to check for irregular or tightened movement. These are all of the tests that are typically necessary to determine whether or not you have contracted Dupuytren’s Disease.

Treatment

Dupuytren’s cannot be cured, but can be treated. If the condition is developing fairly slowly, causes no pain, and does not have much impact on your hand usage for daily tasks, then treatment may not even be necessary. In this case, treatment may occur later, depending on the progression of the contractures.

If treatment is needed, the goal is to either remove or break the cords that are pulling your fingers towards your palm. There are multiple ways to do this, and the method would depend on your health issues and severity of symptoms:

Needle Aponeurotomy (Needling)

This process is simply a needle piercing the skin to puncture the cords in the tissue that are pulling the fingers towards the palm. The contractures usually will reoccur, but this procedure can then be repeated again. It is typically a fast procedure, since multiple fingers can be done at once, but will not work in locations where a nerve or tendon could potentially be damaged.

Enzyme Injections

This method involves injecting an enzyme into the cords of tissue in the palm, which will weaken it, allowing the doctor to move the hand in such a way to break the cord, thus straightening the fingers.

Surgery

Typically a last resort method, because it is very challenging to identity tissue in early stages of this condition. Some affected tissue may attach to the skin as well, which causes difficulty in removing it, and increases the chances of reoccurrence even after removal. Although this method is more complete than the two mentioned above, physical therapy is required afterwards, and recovery times are longer.

 

 


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