Although this is up for discussion, legend has it that the illness was first discovered by the Vikings in Northern Europe. Later, Guillaume Dupuytren, a French surgeon from the 19th century who performed the first successful operation on the ailment, was honored with the name. In the twenty-first century, approximately one in every twenty Americans suffers from Dupuytren's contracture.
What is the contracture of Dupuytren?
The layer of fibrous tissue beneath the skin of the palm and fingers is called the fascia. This tissue becomes thicker and shorter in Dupuytren's contracture.
Initially, this enlarged region was a hard lump known as a nodule. It may develop into a thick band known as a cord over several years or decades, causing one or more fingers to curl toward the palm and become locked there, bent. This can make it challenging to use a computer, button garments, hold things, and carry out other daily chores.
It's not always the case that the illness gets worse and worse. For years, it might not change or, in certain cases, get better.
Which fingers have the highest chance of being impacted?
Most frequently, the ring and pinky fingers are impacted. However, the thumb and all fingers may be affected.
"The condition can affect both hands in about half of the cases," according to Dr. Phillip Blazar, Division Chief of Hand and Upper Extremity at Brigham and Women's Hospital, which is connected with Harvard Medical School. Thankfully, it doesn't hurt too often.
What leads to the contracture of Dupuytren?
As of right now, the reason is unknown. However, a number of variables can raise an individual's risk, including
Genetics: People with Scandinavian, British Isles, or Northern European ancestry are more likely to have this disorder.
Gender: More males than women are impacted.
Age: After age 50, the syndrome frequently manifests.
The illness runs in the family.
Dupuytren's disease is also more common in those who have diabetes and seizure problems. Following hand trauma, the syndrome may manifest and/or deteriorate further.
How is the contracture of Dupuytren handled?
Treatments, including physical or occupational therapy, can help manage symptoms and increase finger mobility, even if there is no known cure. "Many people who have mild cases of Dupuytren's find it has little impact on their ability to use their hands," said Dr. Blazar.
Moderate to severe cases, however, may impair hand function. Normal finger motion can be regained with nonsurgical methods like:
Collagenase injections. The doctor's office is the setting for this procedure. Your hand's cords are injected with collagenase, an enzyme that dissolves and breaks down thicker tissue. During a follow-up appointment, your physician will administer a local anesthetic and use your fingers to manipulate and straighten in the direction that prevents them from moving in order to snap the cords.
Aponeurotomy with needles. During this in-office operation, the restricting cords are weakened and broken by repeatedly putting a hypodermic needle through them.
Your hand surgeon will go over both treatment options to determine which is best for you. There are also certain differences in the architecture of the disease that may make one treatment less effective for a specific person or finger. Both of these therapies do not eradicate the cords, and the problem may reoccur and necessitate further therapy.
How about surgical treatment?
If nonsurgical treatment does not alleviate symptoms or the condition is severe, surgery may be indicated. The surgical approaches include:
Fasciotomy. An incision is made in your palm to separate the thicker tissue from the cord.
Subtotal palmar fasciectomy. A zigzag incision is performed along the hand's creases to remove the aberrant tissue and cord. A skin graft may be required to help the wound heal.
During the healing process, you wear a splint on your restored hand. People should anticipate feeling discomfort, stiffness, and swelling thereafter. The period of recuperation varies by individual and depends on how many and which fingers were operated on.
"Most people largely recover by three months, but some may not feel fully recovered for quite a bit longer," Dr. Blazar said. Hand therapists can also assist with strengthening and flexibility exercises to accelerate rehabilitation.
Most people's fingers move more freely after surgery. However, as with nonsurgical treatments, the contracture can recur, so some people may require additional surgery later on.
