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Dupuytren’s contracture is a disease of the hand. The symptom is flexion contracture of the fingers, the so-called palmar fascia. The causes of Dupuytrene’s contracture are unknown. It is assumed that the development of the disease is favored by past injuries, degenerations and genetic predispositions. Treatment is based on surgical intervention or injections, depending on the patient’s symptoms.
Triggers of Dupuytren’s Contracture?
Dupuytren’s contracture it mainly affects men over 40 and is of genetic origin. However, there is a link contracture with previous diseases, microtraumas that may cause fibrosis. The influence of injuries to the ulnar nerve on the flexion contracture of the fingers was also noted. Another of the triggering factors Dupuytren’s contracture may be insulin-dependent diabetes, alcoholism, smoking or performing work that strains the wrist.
Dupuytren’s contracture – symptoms
The disease appears most often in both hands, but it manifests itself with varying degrees of severity. Contracture hinders everyday functioning. One of the first symptoms there is pain in the flexion of the fingers on the inside of the hand. The pain is localized in the tendon of the middle finger. Another with symptoms there is a restriction of finger mobility and a characteristic “jumping” sound. Dupuytren’s contracture at an advanced stage of development, it limits the efficiency of gripping. What are the others symptoms? Among other things, tingling in the hand, high sweating or blood supply disorders (cold hands). symptoms can be divided into 3 phases:
- Proliferation – the patient notices the first symptoms of the disease.
- Hypertrophy of the aponeurosis – thickenings, overgrowths, nodules become visible and a slight contracture is felt when you try to straighten the hand.
- Contracture fixation – this is the advanced phase of the disease, during which dense fibers are formed on the hand, making it difficult to move.
Dupuytren’s contracture – surgery and treatment
It is possible leczenie pharmacological, operational and rehabilitation. Nonsurgical treatment of contracture is based on the administration of collagenase, which contains an enzyme that dissolves tissue strands, causing Dupuytren’s contracture. The drug is injected into the diseased tissue under ultrasound guidance. Then, with the help of appropriate manual therapy, straighten your fingers. Surgical intervention, on the other hand, is recommended to patients with a significant development of the disease, limiting their normal daily functioning. Patients with advanced disease complain of problems with folding their hands as if for prayer, pain when keeping their hands in their pockets, or the inability to place their hands on a flat surface. The surgical procedure to bring relief to the patient is called fasciotomii. It involves inserting a scalpel under the skin and cutting the fascia, which blocks the natural bending of the fingers. Fasciotomy Subcutaneous is a particularly good treatment for the elderly, because it is minimally invasive and requires only local anesthesia, which is not burdensome for the body like general anesthesia. The only effective method so far treatment there is surgery on the affected area.
Complications after surgery
If the scar formed at the site of the procedure is not properly cared for, discomfort and pain may arise from scarring the wound. Such a scar can be broken with the help of appropriate massages performed by a qualified physiotherapist. Other possible complications there are hematomas, bruises, swelling, bacterial infections, nerve damage and chronic pain. Unfortunately, the operation does not provide a full lifetime guarantee to get rid of the problem.
Dupuytren’s contracture – physiotherapy
Rehabilitation is recommended immediately after the surgery, before the wound heals. If it is not performed in a timely manner, sensory disturbances and even necrosis may result.
Dupuytren’s contracture – exercises
Hand exercises, which you can do yourself at home, are a very important element in the whole process of treating ailments. Every day you need to rub the pain area using the transverse method. In case of severe pain, it is worth massaging the hand towards the forearm. Another with exercise there may be stretching of a contracted tendon.