Dupuytren’s Contracture : Causes,Symptoms,Diagnosis & Treatment
Dupuytren’s contracture is a condition that affects the hands and fingers. A Dupuytren’s contracture is a localized formation of an abnormal thickening of the scar tissue just beneath the skin.
Dupuytren’s contracture is ordinarily started as small hard nodules just under the skin of the palm. It later worsens over time until the fingers can no longer be straightened. Its typically not painful some aching or itching may be present. The ring finger followed by the little and middle fingers are usually affected most.
Dupuytren's Contracture Causes
The exact Dupuytren's contracture cause is unknown, However, it is known that Dupuytren's contracture occurs more frequently in patients with diabetes mellitus, seizure disorders (epilepsy), and alcoholism. A Dupuytren's contracture can be inherited, it’s thought to be related to your genes, as it often runs in families.
Typically, a Dupuytren's contractures occur in males over the age of 50. It is more common in males.
Dupuytren's Contracture Symptoms
A Dupuytren's contracture usually includes a minor painless lump in the palm of the hand near the base of the finger(s). The ring and little finger are affected most commonly.A Dupuytren's contracture can also affect one or both hands.
As a Dupuytren's contracture advances, it can commence an inability to fully extend the affected finger from the flexed position. As the fingers are drawn into the palm, it may be difficult to wash hands, shake hands, wear gloves and get hands into pockets. This can result in a loss of normal grasping.
Dupuytren's Contracture Diagnosis
A Dupuytren's contracture is diagnosed by the physician throughout the physical examination of the affected hand. X-rays and other tests are not normally necessary.There may be three types of Dupuytren's contracture-
- Type 1 Dupuytren's contracture: A very aggressive form of the disease found in only 3% of people with men under 50 with a family history of Dupuytren's.
- Type 2 Dupuytren's contracture: The more normal type of Dupuytren's disease, usually above the age of 50. This type may be severe by such as diabetes or heavy manual labour.
- Type 3 Dupuytren's contracture: A mild form of Dupuytren's which is common on certain medications such as the anti-convulsants taken by people with epilepsy. This type does not commence to full contracture of the fingers.
Previous burns or hand injury can commence to scar generation in the palm of the hand that can imitate true a Dupuytren's contracture.
Dupuytren's Contracture Treatment
Nonsurgical Dupuytren's Contracture Treatment
Corticosteroids are effectual anti-inflammatory that can be injected into a tender nodule, a first line approach for Dupuytren's Contracture treatment. In some instances, a corticosteroid injection may slow the progression of a contracture.
Forceful stretching of the contracted finger may not be effective and it causes an injury to the finger or hand.
Splinting and hand therapy usually required after treatment for Dupuytren's Contracture in order to maintain the improved finger function.
A newer method is collagenase (Xiaflex) injection. The scar tissue that forms the contracture is composed of collagen. Collagenase is an enzyme that breaks up the collagen, Collagenase is directly injected into the contracted "cord" of scar tissue.
Surgical Dupuytren's Contracture Treatment
For patients with notable fixed flexed contracture of the fingers and nonsurgical Dupuytren's Contracture treatments have failed, surgical procedures can release the scarred tissue by carefully cutting it with a needle. This procedure is attributed to as a needle aponeurotomy or needle fasciotomy.