Dupuytren's contracture is a thickening and shortening of this web of fascia that gradually causes clawing of the fingers as they are pulled towards the palm. The ring and little finger are usually targeted, but any finger can be affected.
Dupuytren's contracture mainly affects the ring and little fingers. You can have it in both hands at the same time. It tends to get slowly worse over many months or years.
There are no proven ways to prevent Dupuytren's disease or limit its progress. Hand therapy and rehabilitation using thermoplastic night splints and regular physiotherapy exercises may aid in the postoperative recovery period.
Dupuytren contracture most commonly affects the two fingers farthest from the thumb. The condition often occurs in both hands.
The condition usually affects the fourth and fifth fingers, known as the ring finger and the little finger or pinky. However, the thickening can extend into any of the digits, including the thumb. Other names for Dupuytren's contracture are Morbus Dupuytren, Dupuytren's disease, and palmar fibromatosis.
Dupuytren's contracture is a deformity of the hand due to thickening and fibrosis of the palmar aponeurosis and eventual contracture of the 4th and 5th digits.
The ulnar nerve is also responsible for sensation in the fourth and fifth fingers (ring and little fingers) of the hand, part of the palm and the underside of the forearm. Ulnar nerve entrapment can cause pain, numbness and tingling in the forearm and the fourth and fifth fingers.
The cause of Dupuytren's contracture is unknown, but risk factors include advancing age, Scandinavian and Celtic ancestry, and certain conditions such as epilepsy, alcoholism and diabetes. Treatment options include injections of corticosteroids into the palm and surgery.
Smoking and drinking.
Hand injury and occupations that cause excessive hand wear and tear are frequently mentioned as risk factors, but they don't cause the condition. “Trauma doesn't cause Dupuytren's contracture, but it may make the condition worse and speed up the development of hand deformity,” Evans says.
In 10% of the cases with bilateral disease, it started simultaneously in both hands. One woman and two men noticed the first symptom before 10 years of age. In about 50% of the men, the disease started between 40-59 years of age (women 40-69 years).
Vitamin D deficiency may stimulate fibroblasts in Dupuytren's disease via mitochondrial increased reactive oxygen species through upregulating transforming growth factor-β1.
A Dupuytren's contracture typically progresses very slowly, over a period of years. Signs and symptoms of the condition may include: Nodules. You may develop one or more small lumps, or nodules, in the palm of your hand.
If left untreated, Dupuytren's contracture can be debilitating. As the condition progresses, it can limit your ability to open your hand fully, grasp small objects, or insert your hands in narrow spaces.
Dupuytren's contracture: This form of arthritis causes the tissue beneath the hand to develop nodules in the fingers and palms. These lumps can cause the fingers to stick in place.
Dupuytren disease is a genetic disorder that often is inherited in an autosomal dominant fashion, but is most frequently seen with a multifactorial etiology. It is associated with diabetes, seizure disorders, smoking, alcoholism, HIV, and vascular disease.
A healthy diet can keep Dupuytren's contracture from worsening. Like arthritis, inflammation can speed up symptoms. However, a diet full of fresh fruits and vegetables naturally reduces inflammation. Studies show that magnesium and vitamin E also reduce inflammation and taking a daily supplement may help.
Early Signs of Dupuytren's Contracture
The skin might appear puckered as knots (nodules) of hard tissue begin to form on your palm. These nodules might feel tender to the touch, but they're usually not painful. The thickening of the skin usually happens very slowly.
Dupuytren nodules have been discovered to contain dense T-cell infiltrates, suggesting it is a T cell-mediated autoimmune disorder.
Your hand will be numbed (using local anaesthetic) or you may be put to sleep (using general anaesthetic). Cuts will be made along your palm and finger and the thick tissue causing the contracture will be removed. This is the most common surgery for Dupuytren's contracture.
Although both Dupuytren's disease and trigger finger share several common risk factors, no clear associations have been identified between the 2 disease processes.
See your doctor if you experience intermittent numbness or tingling in one or both hands. Get emergency medical care if the numbness: Began suddenly. Follows an injury or accident.
Persistent pins and needles may be symptomatic of more serious conditions, such as nerve injury or inflammation. Always see your doctor if you experience persistent or frequent episodes of pins and needles.
Nerve Injury
2 Dupuytren's cords can be closely wrapped around nerves in the fingers and sometimes the cord pulls the nerve into an unexpected location. With any invasive treatment, the nerve can be injured. When a nerve injury occurs, the finger can develop tingling or numbness and this can be a permanent problem.