Dupuytren’s Contracture

Dupuytren’s Contracture

Dupuytren contracture, also known as palmer fibromatosis or morbus Dupuytren, is an abnormal thickening and tightening of tissue that lies underneath the skin of palm and fingers. The condition results in the formation of bumps, firm pits, and knocks, which leads to bending and straightening of the finger. This deformity develops over the years, and the affected fingers cannot be straightened completely.

The primary cause of Dupuytren’s contracture is not known. The ailment is common in aged people. However, certain biochemical aspects may be involved that may affect palm’s connective tissue. Some of the factors involved in the development of Dupuytren’s contracture include binge drinking, diabetes, smoking, seizures, old age, and family history of the condition. 

Symptoms 

The symptoms of Dupuytren contracture progress slowly, and condition can lead from mild to worse. The symptoms that have been observed in most clinical cases include; 

  • Difficulty in placing the hand flat
  • Thickening of the skin on the palm area
  • Formation of lumps and pits within the palm
  • The sensation of pain while touching the affected area
  • Difficulty in working with hand

Treatment Options

Treatment of Dupuytren’s contracture depends upon the severity and the symptoms observed. In mild cases, surgery may not even be required. Multiple treatment options are available that may include;

Non-surgical treatment

The goal of the treatment to recover the function and motion of the crooked finger. Non-surgical treatments are always available which include; 

  • Stretching – Stretching the finger can help in speeding up the curling of the finger. Hand therapy and relaxing the contractile using massage are also recommended to maintain the proper functioning of the finger. 
  • Steroid injections – Powerful anti-inflammatory injections are injected into Dupuytren’s nodule. The injections help to reduce the size of nodules by breaking the cord apart. Steroid injection also contributes to preventing the condition from getting worse.
  • Enzyme injections – The specific mixture of Enzymes is injected into the taut cord of the palm to soften it so that cord can be broken down for straightening of the finger. This procedure is performed a day before the surgery. 

Surgical treatment

Surgical intervention is recommended in the case of advanced disease, when all non-surgical treatments fail to work, and the hand’s function is severely limited. 

  • Removal of cord tissue – This operation involves the cutting and complete removal of the thick cord of the palm that is causing deformity and restoring the function and motion of the finger. 
  • Needle aponeurotomy – This procedure is an alternative to open surgery. Instead of an open incision, a sharp end of the needle is used to cut the thick band present underneath the skin. It provides faster recovery and is a less complicated procedure. 
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