تعريف
Dupuytrens contracture is a thickening and shortening of the fascia in the palm of the hand. The fascia is a firm tissue that lies just below the skin. This condition causes affected fingers to curl towards the palm and makes extension of these fingers difficult or impossible.
أسباب
The exact cause of Dupuytrens contracture is unknown. For some people, the condition is inherited.
عوامل الخطر
عامل الخطر هو الشيء الذي يزيد من فرصتك في الإصابة بمرض أو حالة.
- Age: 40 and over
- الجنس : ذكر
- A parent with Dupuytrens contracture
- مدمن كحول
- الصرع
- Use of certain anticonvulsant medications for epilepsy
- مرض الكبد
- التدخين
- مرض السكري
الأعراض
At first, symptoms are mild, but they may become progressively worse. The rate of progression varies among people.
The ring finger is usually affected first, followed by the little finger, then the index, and long finger. Fingers on either or both hands can be affected. The first sign of this condition is a nodule in the palm near the base of a finger. A nodule is a small thickening of the fascia under the skin. In some cases, nodules can be sensitive to touch. Generally, though, this condition is not painful.
As a contracture progresses, the nodule becomes a thickened fibrous cord that extends into the finger under the skin. As the cord thickens and shortens, the affected finger is pulled (curled) in towards the palm. It becomes difficult or impossible to extend the finger.
التشخيص
The doctor will ask about your symptoms and medical history. A hand examination will be done. In some cases, x-rays may be taken as well.
العلاج
No treatment is necessary when symptoms are mild and do not effect normal use of the hand. In other cases, treatment may include:
جراحة
Surgery is most effective when the condition is still in the nodule stage.
Depending on how far the condition has progressed, surgery may involve:
- Making small incisions in the thickened tissue
- Removing diseased tissue
- Removing diseased tissue and overlying damaged skin, and then repairing resulting gaps in skin with skin grafts
- Percutaneous needle fasciotomy
Exercise Therapy After Surgery
This is usually needed to restore full range of motion and use of the repaired finger(s).
Dupuytrens contracture can recur after surgery.
Injected Medication
Injecting corticosteroids into nodules during early stages of the condition can sometimes:
- Delay the progressive worsening of the condition
- Ease any tenderness that may be present in the nodules
Another medicine that can be injected is called collagenase clostridium histolyticum (Xiaflex). This biologic drug breaks down the thickened tissue in the hand.
If you are diagnosed with Dupuytrens contracture, follow your doctor’s instructions .
الوقاية
There are no guidelines to prevent Dupuytrens contracture. Its cause is unknown. However, treatment is made easier and more effective with early detection.
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