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Dupuytren’s contracture

Dupuytren’s contracture

Definition of

Progressive flexion contracture of usually the 4th and 5th fingers (others are also possible) due to fibrosing changes in the aponeurosis of the palm combined with cord and nodule formation. Mainly men are affected, usually from the age of 50. Often in combination with diabetes mellitus or liver disease, in 70-80% of cases on both sides. As a fibromatosis, this disease is similar to Ledderhose disease, a fibromatosis of the plantar fascia of the foot.

ICD M72

Cause

1. Predominantly idiopathic, also familial clustering
2. There is a connection with liver cirrhosis, diabetes mellitus, alcoholism

Symptoms

1. Stage 1: lumps (bumps) form in the palm of the hand without restricting finger flexibility(bending, stretching, spreading)
2. Stage 2: Hardening of the aponeurosis, which extends to the metacarpophalangeal joint, resulting in slight flexion in the metacarpophalangeal joint
3. Stage 3: Hardening spreads to the tendons, progressing from the metacarpophalangeal joint to the metacarpophalangeal joint, resulting in flexion contracture of the metacarpophalangealand metacarpophalangeal joints
4. Stage 4: Joint capsules fixed in flexed position and atrophied m. interossei with additional extensor contracture (hyperextension) in the end joint, possibly leading to loss of function of the hand

Therapy

1. Surgery with partial resection of the aponeurosis; pronounced tendency to recur; it is important to start movement exercises as soon as possible after surgery