Treatment of Dupuytren Contracture
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Municipal Hospital Karlsruhe
Department of Adult and Pediatric Traumatology, Orthopedic Surgery, Hand and Foot Surgery
University Hospital Frankfurt am Main
Department of Adult and Pediatric Trauma, Hand and Reconstructive Surgery
University Hospital Carl Gustav Carus Dresden
Department of Adult and Pediatric Orthopedics, Trauma Surgery, Foot Surgery
University Hospital Würzburg
Department of Traumatology, Hand Surgery, Plastic and Reconstructive Surgery
University Hospital Erlangen
Department of Plastic, Aesthetic and Reconstructive Surgery, Adult and Pediatric Hand Surgery
University Hospital Hamburg-Eppendorf
Department of Trauma, Hand and Reconstructive Surgery
University Hospital Bonn
Department of Orthopedics and Traumatology
University Hospital of Ludwig Maximilian University of Munich
Department of Adult and Pediatric Orthopedics, Foot Surgery
University Hospital RWTH Aachen
Department of Plastic, Burn Surgery and Hand Surgery
University Hospital Marburg UKGM
Department of Orthopedics and Traumatology
University Hospital Duesseldorf
Department of Adult and Pediatric Traumatology, Hand Surgery
University Hospital Jena
Department of Adult and Pediatric Trauma, Hand, Reconstructive Surgery
University Hospital Rechts der Isar Munich
Department of Adult and Pediatric Plastic Surgery, Hand Surgery
University Hospital Muenster
Department of Adult and Pediatric Traumatology, Hand and Reconstructive Surgery
University Hospital Essen
Department of Adult and Pediatric Orthopedics and Traumatology
Dupuytren’s contracture is the thickening of the tissue on the palm of the hand, which should normally be elastic. This tissue, also known as fascia, consists of fibers that run from the palm to the fingers, like cords. In people with Dupuytren’s contracture, these fibers tighten and contract. As a result, the fingers start to curl inward. If not treated in time, this condition can result in hand deformities.
It is not known what exactly causes Dupuytren’s contracture. Some doctors believe that it develops due to some biochemical substances that affect the connective tissue of the palms. This condition is not caused by age, arthritis or injuries, as tendons are not damaged. However, excessive alcoholism and smoking can contribute to the development of Dupuytren’s contracture in people who have a genetic predisposition to it. More common in men over 40, Dupuytren’s contracture mostly affects people of Northern European origin. In 90% of cases, both hands are affected.
- Fingers curl inwards towards the palm of the hand
- Lumps appear under the palm, which is tender and sore
- It is difficult to stretch the fingers
- The ring finger is clenched
- A physical examination is usually enough to diagnose Dupuytren’s contracture. The doctor will try to straighten out the patient’s hands to examine the palms and fingers. This should be enough to determine the amount of nodules under the skin.
- A X-ray of the palm is used to determine whether there are any problems with the patient’s bones, which would rule out Dupuytren’s contracture.
- Conservative treatment includes injections of corticosteroid medications that can help to reduce the swelling and pain caused by the nodules in the palm.
- Surgical treatment aims to resect the thickened bands of connective tissue under the palm that is making the fingers curl inwards. After surgery, the patient will need to wait several weeks until the swelling disappears and he/she can move the hand normally again.
In most cases, treatment is successful and brings good results.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed