Dupuytren contracture

Dupuytren contracture: Description, Causes and Risk Factors:ICD-10: M72.0Alternative Name: Viking's disease.Def: A disease of the palmar fascia resulting in thickening and shortening of fibrous bands on the palmar surface of the hand and fingers resulting in a characteristic flexion deformity of the fourth and fifth digits.Dupuytren contractureDupuytren contracture is a contracture of the palmar fascia that usually causes the ring and little fingers to bend into the palm so they cannot be extended.The exact causes of Dupuytren contracture  are not yet known, although it may be genetically linked. There is a strong family linkage to this disease but in most cases we do not know why people get this problem. Sometimes we can trace the cause to diabetes, liver disease smoking or alcohol intake. At present we do not think there is a link between Dupuytren's and work.The pathophysiologic basis of Dupuytren contracture is believed to be local microvessel ischemia and platelet and fibroblast derived growth factors that promote myofibroblast populations with altered collagen profiles.Risk Factors May Include:Age - the condition is more common in middle to later years of life.
  • Gender - up to 10 times more men than women are affected.
  • Heredity - the condition tends to run in families.
  • Ancestry - those with Celtic or Scandinavian ancestry are at increased risk.
  • Certain medical conditions - people with diabetes and epilepsy have a higher incidence of the condition.
  • Alcoholism - the contracture tends to be common, and comparatively more severe, in alcoholics.
Dupuytren contracture commonly gets worse over time. In some people it gets worse very quickly, in others it changes very little over the years.Symptoms:Dupuytren contracture Symptoms may include the following:A lump or nodule appears on the palm, usually close to the base of the ring or little finger.
  • There is the appearance of a thickened cord running along the palm to the fingers.
  • Over time, as the contracture develops, the fingers become clawed as they are pulled towards the palm.
  • The hand bows.
  • The fingers are completely pulled against the palm.
  • Often, the skin of the palm is dimpled and puckered.
  • There is rarely any associated pain.
Diagnosis:In most cases, though, doctors can diagnose Dupuytren contracture  simply by looking at and feeling your hands.A physical examination of the palm by palpation confirms the presence of thickened scar tissue (fibrosis) and contracture. Restriction of motion is common.A simple maneuver, called the tabletop test, can determine if you have a contracture in your hand. If you can lay your hand, palm down, flat on a tabletop, you don't have a contracture.Treatment:No surgical or nonoperative therapy has proven effective against Dupuytren contracture. Local corticosteroid and collagenase injections; radiotherapy; treatment with calcium channel blockers, prostaglandin E1, and prostaglandin E2; and surgical release of contracture have all been used with varying degrees of success. Recurrence is common and therapy is mostly empirical.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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