Reasons For Dupuytren’s Contracture And Its Treatments

Dupuytren’s contracture is a deformity of the hand that primarily affects the movement of the fingers. The disorder destroys the tissue that lies just under the skin of the palm. It develops over the years, and is most common in men over 45 years of age.

The disease affects both hands in half of the people who have it. In addition, it occurs twice as often on the right hand than on the left hand when only one of the hands is affected.

The contracture restricts the movement of the fingers and prevents them from extending completely. It can present challenges in everyday life. It primarily affects the ring and little fingers.

Taking your hands in your pocket, putting on gloves and waving are just some of the most limited movements. In this article, we explain to you all about Dupuytren’s contracture.

Related symptoms

Dupuytren’s contracture develops slowly, but it will eventually reduce the functionality of the affected hand.

It starts with the skin in the palm becoming thicker. Later, the skin gets wrinkled and gets cavities on the surface. There may also be small nodules.

These knots become thicker until they eventually take the shape of a cable. The area may be sensitive but without pain. The nodule that lies under the skin can pull on one or more fingers and keep them bent. It can make the hand look like a claw.

Reasons for Dupuytren’s contracture

The specific cause of Dupuytren’s contracture is still unknown, although experts believe it may be something hereditary,  primarily affecting men.

Risk factors

Dupuytren’s contracture occurs with varying frequency depending on the genetics and characteristics of the individual. It more often affects alcoholics and people with epilepsy.

There are several cases in northern European countries and similar areas. In contrast, it is rare in Africa and East Asia.

Some of the risk factors for the disease are:

• To be older than 50 years.
• It hits men 7 to 10 times more often than women.
• Dupuytren’s contracture appears to be hereditary.
• Diabetics are at increased risk, probably due to a chronic damage to collagen.
• Smoking increases the risk due to small damage to the blood cells.
• Alcohol consumption leads to metabolism of toxins and liver damage.

Treatments of Dupuytren’s contracture

One of the first steps in treatment is to keep mild and non-developing cases under observation. It is a form of treatment that should be considered as it does not limit the function.

Injections with cortisone into the lump can reduce the sensation if it happens before the fingers begin to bend. However, it is important to mention that cortisone does not slow down development.

Another treatment is the injection of collagenase, the results of which are quite good. Collagenase is an enzyme that dissolves the collagen that forms the nodule of the palm.

It is one made on the bacterium Clostridium histolyticum. It can soften and weaken the knot, eventually breaking it down so that the fingers can be stretched out.

In some European countries, radiation therapy is used, which has also given good results. It delays the development of the disease and the need for surgery. Doctors usually use it only once.

Acupuncture

The patient can get acupuncture before the operation. Here a needle is inserted through the skin. The goal is to destroy the tissue in the knot, which causes the fingers to bend.

The advantage is that it does not require surgery and doctors can do it on several fingers at a time. Subsequently, it requires only a little physiotherapy. The major drawback, however, is that the contracture may recur.

Operation

This is only in the case that the palm can not stay still on a table. And if the fingers are so bent that the mobility is reduced, or if it goes beyond several fingers.

Here, the goal is to remove the tissue affected by the disease. The main advantage is that the result lasts longer than with injection of collagenase or acupuncture.

In severe cases, all the tissue affected by Dupuytren’s contracture will be removed, including the skin at the nodule. Here, a skin graft will be needed to cover the wound.

Advice and prevention

The following changes in activities are recommended for people with Dupuytren’s contracture:

• Protect your hands with soft gloves when lifting heavy objects.
• Apply foam or soft tape to the handles of objects and tools.

Physiotherapy can also help with the pain and increase mobility. The following techniques can be used:

• Heat therapy.
• Ultrasound.
• Stretching exercises.

Dupuytren’s contracture is progressive

Dupuytren’s contracture may develop unpredictably. It causes deformities and lost mobility in the affected hand. Therefore, it is important to discover and keep an eye on it.

Cases that require surgery can be complemented with physiotherapy. Primarily to reduce symptoms and improve hand functions. The ultimate goal is to improve finger mobility.