Dupuytren contracture occurs in about 5% of people in the United States. The disease is 3 to 10 times more common in people of European origin than in people of non-European origin. Although reports of Dupuytren`s contracture first appeared in the medical literature in the 1600s, doctors still do not know what causes scar tissue to form. The disease tends to work in families, so genes may be involved. Dupuytren is more common in middle age, especially in men of Northern European descent. Alcohol and tobacco use, diabetes and epilepsy also increase the risk. A procedure called aponevotomy is an alternative to traditional surgery for Dupuytren`s contracture. Instead of an open cut, it uses the pointed end of a needle to cut the thick strips under the skin, which can help you recover faster. However, it doesn`t work as well for people with more severe cases. Overall, the risk of complications is lower, but there is a risk of nerve, blood or tendon damage.
Needle aponevotomy is even more effective when used in combination with corticosteroid injections. A specialized hand surgeon must perform this procedure. Ask your doctor what type of surgery is best for you. Treatments for Dupuytren`s contracture may include: About a quarter of people with Dupuytren`s contracture experience unpleasant inflammation or feelings of tenderness, burning, or itching in the affected hand. They may also feel pressure or tension, especially if they are trying to straighten the affected joints. Dupuytren`s contracture is not a dangerous condition, but it can be disabling if it becomes severe. Dupuytren contracture is a benign thickening of the palmar fascia (a dense network of fibers that gives the skin of the palm its stability), characterized by the presence of excess collagen. Small nodules or depressions are usually the first signs of dupuytren. Later, thick cords are formed, which pull the affected fingers down towards the palm of the hand.
Dupuytren usually appears after the age of 40 and becomes more common with age. It is more common in men than in women. The younger a person is, as Dupuytren develops, the more severe the disease is likely to become. Dupuytren contracture occurs when the tissue under the skin near your fingers becomes thicker and less flexible. Dupuytren contracture occurs when 1 or more finger leans towards your palm. There is no cure, but your fingers can be stretched if they are heavy. In some cases, Dupuytren`s contracture is not hereditary and occurs in people who have no history of the disease in their family. These sporadic cases tend to start later and are less severe than familial cases. Dupuytren contracture (du-pwe-TRANZ) is a condition that gradually causes the connective tissue (fascia) to thicken under the skin of your palm and becomes frightening. Although Dupuytren is not always painful, it restricts movement. The thickened fabric forces several fingers – usually your ring and little fingers – to roll towards your palm.
The curvature caused by the thick tissue is called contracture. The abnormal proliferation and differentiation of connective tissue cells called fibroblasts are important for the development of Dupuytren`s contracture. The fascia of people with this disorder has an excess of myofibroblasts, which are a type of fibroblasts that contain strands of protein called myofibrils. Myofibrils usually form the basic unit of muscle fibers, which allows them to contract. The increased number of myofibroblasts in this condition causes an abnormal contraction of the fascia and produces excessive amounts of a connective tissue protein called type III collagen. The combination of abnormal contraction and excess type III collagen is likely to result in the changes in connective tissue that occur with Dupuytren`s contracture. However, it is not known how changes in genes that affect the Wnt signaling pathway are related to these abnormalities and how they contribute to the risk of developing this disorder. Other risk factors for developing Dupuytren`s contracture may include smoking; extreme alcohol consumption; liver disease; diabetes; high cholesterol; thyroid problems; certain medications, such as those used to treat epilepsy (anticonvulsants) and previous injuries to the hand. Dupuytren contracture is characterized by a deformation of the hand, in which the joints of one or more fingers can not be completely straightened (extended); Their mobility is limited to a series of curved (folded) positions. The condition is a connective tissue disorder that supports the muscles, joints, organs and skin of the body, giving strength and flexibility to structures throughout the body. In particular, Dupuytren`s contracture results from the shortening and thickening of connective tissue in the hand, including fat and ligaments of fibrous tissue called fascia; The skin is also involved.
The symptoms of Dupuytren`s contracture may resemble other health problems. Always contact your doctor for a diagnosis. There is no imaging or blood tests to confirm the presence of Dupuytren`s contracture. “This is a purely clinical discovery,” says Dr. Swigart. She says the diagnosis is based on symptoms reported by patients, observations and results of physical examinations. Talk to a specialist about options, benefits and risks and what you can expect next. Your doctor can usually determine if you have Dupuytren by feeling the thickened scar tissue and seeing if your fingers are pulling inward. You can also take a “table” test, where you place your hand on a table with your palm down to see if it`s flat. If this is not the case, you may have a contracture that may require surgery. Your doctor may also test your grip and range of motion in your fingers.
The presence of a mass in the palm of the hand does not mean that treatment is necessary or that the disease is progressing. In addition, not all the pieces in the palm of the hand are dupuytres. Therefore, it may be helpful to consult a hand surgeon for an examination. Sometimes a medical history and an examination are enough to assess a mass. In other cases, imaging such as X-ray, ultrasound or MRI may be indicated. Some important factors when evaluating masses are their size, their “feeling” (e.B. solid or pasty), location, presence of pain, movement of the lump or skin around the mass, family history, and other conditions that may be present. In mild cases, especially if the function of the hand is good, only one observation is necessary. Splints or stretches usually do not prevent deterioration of the contracture, but can be tried safely. For contractures that become troublesome, there are non-surgical and surgical options. These are usually discussed when the contracture prevents the hand from lying flat on a table.
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