23.07.2021 – 16:17
Dupuytren contraction is a condition that causes the palm fascia, the connective tissue that lies beneath the skin in the palm of the hand, to contract or contract. Due to the contraction, the fingers may bend permanently, and the function of the hand is impaired.
The palm fascia is a thick tissue that extends over the tendons and under the skin of the hand. The fascia is attached to both the skin above and the structures below. The palm fascia helps provide a firm, gripping surface for the hand and fingers.
Causes
No one really knows what causes Dupuytren to contract, but it is well known that it goes to the family – 60 percent to 70 percent of individuals have a family history of the condition. Other factors are suspected to cause Dupuytren contraction, such as trauma, diabetes, alcoholism, epilepsy, and liver disease, but there is no clear link.
The condition is more common in the elderly (usually after the age of 40) and in men. There is evidence that trauma may contribute to the development of Dupuytren contracture. It has been studied whether specific traumatic events or a history of manual labor may contribute to this problem. Microscopically, there is evidence of bleeding within the affected tissues, evidence that trauma may contribute to this condition. Dupuytren is often seen in both hands, and is found just as often in the dominant and non-dominant hands – evidence that this problem is not the result of repeated trauma.
Technically, Dupuytren disease refers to the proliferation of cells that cause the formation of joints and contractures. Dupuytren contracture is the result of this cell proliferation and a common manifestation of Dupuytren disease. Treatment of Dupuytren contracture can be considered when the condition causes difficulty in performing normal daily tasks.
For many years, treatment in the early stages of contracting was a waiting situation. Because surgical treatment is invasive and may require prolonged healing and rehabilitation, it was often reserved as a last resort if symptoms begin to interfere too much with daily activities.
Recently, less invasive treatment options have given some hope that Dupuytren contracture can be well managed, especially if treated in the early stages of the problem. The worse the contracture, the harder it will be to have normal hand function again. Therefore, many people are looking for less invasive treatment options, especially for Dupuytren early stage contracture.
treatment
There are four main treatment options currently available for treating Dupuytren contracture:
Observation: Observation is often considered in the early stages of Dupuytren contracting. This is usually the best option for people who are not impaired by hand function. This may include people with minimal contractures or people who can perform all of their usual activities.
Needle aponeurotomy: Needle aponeurotomy is a procedure developed in France, which has only recently become more popular. Using no incision, a needle is used to separate the Dupuytren cords and restore finger movement or full hand movement. Needle aponeurotomy is most successful in the early stages of Dupuytren contracture.
Collagenase injections: Collagenase is an enzyme produced by a bacterium that is injected into the Dupuytren cord. The enzyme works to disperse Dupuytren narrow tissue. The day after the injection, after the enzyme has done its job, you return to the doctor to restore finger movement.
Surgery: Surgery is performed to remove the palm fascia from the palm of the hand. Surgery may be effective in restoring function and may be necessary in the later stages of Dupuytren contracting. Surgery usually has a prolonged rehabilitation.
