Dupuytren’s Contracture is a condition affecting the hands and fingers, in which the finger bends in towards the palm. More than one finger can be affected and it is not always limited to one hand. The condition is most common amongst the older population, with 20% of men over 60 and 20% of women over 80 suffering from it. It is believed to run in families.
The main symptom of Dupuytren’s Contracture is small hard lumps on the palm of the hand. These may be accompanied by tenderness, a thickening in the skin, dimples or pitted marks, and an inability to straighten your fingers as much as you used to. The ring finger is usually the first to be affected. Dupuytren’s contracture is progressive, meaning it gets worse over time and fingers may end up being permanently bent. This can make activities such as doing up buttons or tying a shoelace tricky.
Dupuytren’s contracture occurs when the connective tissue beneath the skin thickens. When nodules subsequently form, they produce excess collagen (the protein that makes bones, skin and tendons) which is what causes the lumps to appear on the skin. The nodules can form a cord over time, which contracts the connective tissue in the hand, making it more difficult to extend the finger.There is no definite cause of Dupuytren’s contracture, however genetics do seem to play a role, as 70% of those diagnosed have a family history of the condition. Men are more prone than women and white northern Europeans develop the condition more than other ethnicities.
Dupuytren’s contracture affects some people more severely than others. When diagnosing the condition, the angle of each joint in the affected finger will be measured. Generally, people start having trouble with everyday tasks when there is a bend of more than 30 degrees. If the bend in the joint where the finger joins the hand (the metacarpophalangeal joint) is more than 40 degrees, minor surgery may be recommended. In mild cases, this will involve the connective tissue being cut to relieve tension, whereas in cases where the hand’s functionality is more severely affected, the connective tissue may be completely removed. Therapy will be helpful after either surgical procedure to improve the function of the hand, however there is a strong possibility that Dupuytren’s contracture may recurr at a later date.
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