alexa Dupuytren's contracture | Japan| PDF | PPT| Case Reports | Symptoms | Treatment

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Dupuytren's Contracture

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  • Dupuytren's contracture (also known as morbus Dupuytren, or Dupuytren's disease and slang terms "Viking disease" or "Celtic hand), is a fixed flexion contracture of the hand due to a palmar fibromatosis, where the fingers bend towards the palm and cannot be fully extended (straightened). Suspected causes of Dupuytren's contracture include trauma, diabetes, epilepsy and therapy with phenytoin. No proven evidence links hand injuries or specific occupational exposures to a higher risk of developing Dupuytren’s. Some speculation links the condition or its onset may be triggered by, physical trauma such as sustained manual labor or over-exertion of the hands. However, the fact that Dupuytren's is not connected with handedness undermines this claim. Dupuytren's contracture typically progresses slowly, over years. The condition usually begins as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled. A firm lump of tissue can form on your palm. This lump might be sensitive to the touch but usually isn't painful.
  • In later stages of Dupuytren's contracture, cords of tissue form under the skin on your palm and can extend up to your fingers. As these cords tighten, your fingers might be pulled toward your palm, sometimes severely. Treatment involves one or more different types of treatment with some hands needing repeated treatment. It is of two types: Surgical and non-surgical. The other alternative treatments are Laser treatments (low power red and infra-red rays); diet supplements (Quercetin, Bromelain, DMSO, Methylsulfonylmethan, Acetylcarnitine Hcl, Para amino benzoic acid, Nattokinase, Vitamin E, Copper, Vitamin C). Radiotherapy has been reported to be effective for prevention of disease progression in early stages with only mild acute or late side effects. X-Ray and more recently E-beam radiation are also used the cease the progression of the disease.
  • The effects of morbidity in Dupuytren contracture are generally limited to lifestyle changes. MCP and PIP joint contractures may interfere with activities of daily living and the nodules can be painful. Racial variation in Dupuytren disease is as follows: The disease prevalence in Asians is 3% and usually involves the palm rather than the digits. Therefore, it is less likely to be clinically significant, and the incidence may be underreported. Approximately 80% of affected individuals are male; this is consistent throughout all countries and races.

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