Dupuytren’s Contractures

Dupuytren’s contracture or Dupuytren’s disease is due to the formation of nodules in the palm and fingers which subsequently cause the fingers to bend towards the palm resulting in a fixed flexion contracture.

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The nodules are due to the thickening of the tissue just deep to the palmar skin (palmar fascia)

Dupuytren’s contracture is a slow growing condition and progresses slowly in the initial stage and are usually painless. Patients with Dupuytren’s contracture usually have difficulty putting their hand in the pocket and wearing gloves. In the severe finger contracture hygiene to the hand can be a problem.

Treatment of Dupuytren’s disease was first described in 1831 by a surgeon named Baron Guillaume Dupuytren in 1831.

Signs & Symptoms of Dupuytren’s Contractures

Patients usually present with hand contractures of varying degrees. In the very initial phase of the condition, it may present with painful nodules. Most patients present with contractures either in the palm of over the finger joints.

Diagnosis and Differentials of Dupuytren’s Contracture

Typically, the diagnosis is clear cut but there are occasions where patient with bowstringing of the flexor tendons can be mistaken for Dupuytren’s contracture.

Management of Dupuytren’s Contractures

Conservative management is generally reserved for patients with mild contractures. Deep tissue massage over the affected area may keep the condition at bay.

Meticulous surgery with selective fasciectomy with complete removal of the longituidinal fascia is more definitive than the other treatment option which include injection with 0.58 mg 0.25 ml. collagenase clostridium histolyticum or percutaneous fasciotomy.

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