Dupuytren's (du-pwe-TRANZ) contractures
are a slow-process condition that lead to hand and finger deformity. It is due
to cord-like tissue that forms under the palms. It may be present in both
hands, though one hand is more affected the other.
Putting on gloves, shaking
hands, and buttoning clothing can be challenging and painful.
It is more common in the right
than the left.
The ring and small fingers
are commonly affected, though the middle finger can be involved. Thumbs and
index fingers are rarely affected. The cause of the problem isn’t known. It
can occur with other conditions that cause contractures in other body parts,
such as the feet.
Risk factors for this
condition include:
Age. It
occurs most commonly after age fifty.
Male gender. Men
are more likely to develop Dupuytren's than women. Their contractures are more severe compared to women.
The
condition is prevalent in older men of Northern European descent.
Dupuytren's
often runs in families.
Smoking may impair blood flow in the fingers, which worsens
the condition.
People
with diabetes are reported to have an increased risk of Dupuytren's
contracture.
A physician’s examination includes
looking for skin puckering on the palms.
The condition can be
diagnosed by a clinical exam in most cases.
Sophisticated testing and x-rays aren’t’ necessary.
Specific treatment may not be indicated. The condition progresses slowly, causes no pain,
and has little impact on daily hand use. However, surgery may be helpful in severe cases.
Needling is a technique that involves insertion of a sterile needle through
the skin to puncture and break the cord tissue that contracts the finger. Contractures
can recur, but the procedure may be repeated. There is possible risk for nerve
or tendon injury.
Enzyme injections into the affected “palm
cord” allows the surgeon to manipulate the patient’s hand and fingers. He injects
an enzyme into the tight palm cord to soften and release the cord, which straighten
the fingers.
Surgery to release the tight hand
tissue can slow the process and relieve
symptoms. It provides a more complete joint release than injections. Post-operative occupational therapy is
prescribed for several months.
Non operative techniques
include finger stretching using the edge of a table, massage and heat, and
avoidance of tight gripping for a few months.
Source:
Medical Blooper: A husband and wife were in the waiting room when the nurse came out to see them. "And what what seems to be the problem with you husband, Mrs. Johnson?" asked the nurse.
"His problem," the woman answered "is that he is constantly worrying about money."
"Ah," said the nurse. "I think the doctor can relieve him of that."
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clementhanson.blogspot.com
