What is Dupuytren's disease?
The fibres which make up the fascia run from the palm to the fingers. The fibrous tissue can thicken and form lumps or cords and can sometimes contract and pull the fingers towards the palm.
What causes Dupuytren's disease?
The exact underlying cause of Dupuytren's disease is not yet known, but it is recognised that it is a hereditary condition and runs in families. It is not thought that injuries, or the overuse of certain hand movements, can cause the condition.
There are, however, certain factors which are believed to affect influence the condition. It is understood that people with Northern European ancestry are at more risk of developing the condition. Other groups with a higher risk factor include men over the age of 40 and you may be more likely to develop Dupuytren's disease if you smoke or have diabetes.
Symptoms of Dupuytren's disease
Typically the initial symptom of Dupuytren's disease is the appearance of a lump (nodule) under the skin of the palm. These lumps can sometimes feel tender, but this usually eases, before the lumps progress to form the tissue cords under the skin. It is these tissue cords which can cause the fingers to bend forwards, towards the palm. The little finger and ring finger are most commonly affected by Dupuytren's disease. People who have Dupuytren's disease often experience symptoms in both hands. The contractures can affect each hand with differing patterns and differing severities. Should the contracture progress, it can become harder to perform everyday tasks, such as putting your hands in your pockets, or picking up large items.
Treatment options for Dupuytren's disease
There is currently no known cure for the condition, but often treatment is not necessary. For patients with early disease, and good hand function, monitoring is often recommended. Certain patterns of contracture are amenable to a small procedure called a needle fasciotomy. This is undertaken under local anaesthetic (skin numbing injection) and a needle is used to cut the cord and the hand is gently manipulated to bring the fingers back out straight. Other patterns of contracture may need surgery to remove the thickened tissue bands under the skin of the palm and increase the range of motion in the digits. Surgery for Dupuytren's generally offers a high chance of a successful outcome and a low recurrence rate.
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