This condition, known as Dupuytren’s disease, derives its name from the French surgeon Baron Dupuytren, who described it in the early 19th century. It is characterized by the thickening and hardening of the palmar fascia, a layer of tissue beneath the skin.
Symptoms:
Inability to fully extend one or more fingers and the presence of a small lump or stiffness in the palm. While Dupuytren’s contracture is typically not accompanied by pain, it can lead to progressive deformity in the hand. Additionally, similar tissue changes can occur in the plantar fascia of the foot. Although the condition most commonly affects the ring finger and little finger, it can potentially impact any finger, the sole of the foot, and even the penis.
The exact cause of Dupuytren’s disease remains unknown, although there is a notable genetic predisposition. It tends to occur more frequently within families, suggesting a hereditary component. Middle-aged men are predominantly affected, with some individuals exhibiting alcoholism or epilepsy, although the underlying reason for this association remains unclear. It is important to note that Dupuytren’s disease is not typically attributed to a single traumatic event.
Diagnosis
The diagnosis of this condition is usually established through a physical examination, as it exhibits distinctive features such as skin indentations. In some cases, there may be a rigid band of tissue beneath the skin that cannot be moved. Contracture is not affected by changes in wrist position.
After the diagnosis is confirmed, it is crucial to monitor the progression of the disease. The healthcare provider may request the patient to place their hand flat on a surface, palm facing downward, to assess finger extension. If the finger cannot be fully extended in this position, it may indicate the need for treatment. Even if the initial test yields negative results, periodic retesting should be considered. Surgical intervention may be recommended if there is evidence of disease progression.
Although this condition is commonly non-painful, the gradual loss of finger flexibility over time can result in discomfort. However, treatment is not always necessary for many individuals.
Surgical Treatment
When surgery is deemed necessary, it typically involves the removal of contracted tissues and, in some cases, grafting of skin from other areas of the body. Following the surgical procedure, the hand will be immobilized with the fingers extended for a few days or weeks. Subsequently, a physical therapy program incorporating finger and hand exercises will be initiated to promote rehabilitation. It is important to note that surgical intervention can often achieve full or significant restoration of normal movement. However, it is possible for some individuals to experience recurrence of discomfort.
