Dupuytren’s Deformity

Dupuytren’s Deformity

Dupuytren’s deformity, also known as Dupuytren’s contracture, is a hand condition that affects the connective tissue under the skin of the palm, causing the fingers—most commonly the ring and little fingers—to become permanently bent in a flexed position. The condition progresses slowly over time and can interfere with hand function, making tasks that require full finger extension difficult.

Key Features
Nodules and Cords

The condition typically begins with the formation of small nodules in the palm, which may be tender. These nodules can progress into thickened cords of tissue that pull the fingers inward.

Finger Contracture

As the condition worsens, the cords tighten and contract, leading to a flexed position of one or more fingers that cannot be fully straightened.

Bilateral Affection

Dupuytren's deformity can affect both hands, although it may be more severe in one hand than the other.

Risk Factors

The exact cause is unknown, but it is more common in older adults, especially males, and is associated with Northern European descent. Risk factors include family history, diabetes, smoking, and alcohol use.

Progression

The progression of Dupuytren's can vary, with some people experiencing rapid worsening of the condition, while in others, it progresses very slowly.

Treatment Options

– Observation: In mild cases with minimal impact on hand function, treatment may not be necessary, and observation is recommended.
– Physical Therapy: Stretching and hand exercises can help maintain finger function, though they do not stop the progression of the disease.
– Steroid Injections: These can be used to reduce pain and inflammation in the early stages.

– Needle Aponeurotomy: A minimally invasive procedure where a needle is used to break the cord of tissue causing the contracture.
– Collagenase Injections: An enzyme injection that breaks down the cord of tissue, allowing the finger to be straightened.
– Surgery: In severe cases, surgical intervention (fasciectomy) may be required to remove the thickened tissue and restore finger extension.

The choice of treatment depends on the severity of the contracture, the impact on hand function, and patient preference. Regular follow-up is often necessary to monitor the progression of the condition.

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