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Dupuytrens Contracture
From WikiSM
Contents
Other Names
- Dupuytren's Disease
- Palmar Fibromatosis
- Morbus Dupuytren
- Viking disease
- Celtic hand
- Contraction of palmar fascia
- Palmar fascial fibromatosis
- Palmar fibromas
Background
- This page refers to Dupuytrens Contracture or Palmar Fibromatosis
History
Epidemiology
- One of the most common fibromatoses
- Northern European descent most affected
- Age peaks at 65
Pathophysiology

A mild case of Dupuytren's affecting the 4th digit.[1]
- General
- This is a benign, proliferative disorder
- Defined by progressive palmer fascial nodules and finger contractions
- Location: ring > small > middle > index
- Proliferation of myofibroblasts, type III collagen
Risk Factors
- Gender
- Male > Female
- Ethnicity
- Caucasian
- Diseases
- HIV
- Alcoholism
- Diabetes Mellitus
- Tobacco Use Disorder
- Thyroid Disease
- Liver Disease
- Hand Trauma
- Epilepsy
- Plantar Fibromatosis
- Peyronie Disease
- Medications
- Antiseizure medications
Differential Diagnosis
- Fractures
- Dislocations
- Tendinopathies
- Ligament Injuries
- Neuropathies
- Arthropathies
- Nail Bed Injuries
- Pediatric Considerations
- Other
Clinical Features
- History
- Loss of range of motion
- Painful Nodules
- Physical Exam: Physical Exam Hand
- Nodules in pretendinous bands of palmer fascia
- Evaluate both hands
- Special Tests
- Table Top Test: Inability to flatten hand out on table
Evaluation
- Primarily a clinical diagnosis
Radiographs
- Standard Radiographs Hand
- Useful to evaluate for other pathology
Classification
- N/A
Management
Nonoperative
- Indications
- Mild contractures
- Comorbidies that preclude surgery
- Physical Therapy
- Emphasis on range of motion exercises
- Procedures
- Injection of collagenase
- Needle Aponeurotomy
Operative
- Indications[2]
- MCP contracture > 30°
- PIP flexion contractures
- Pain not an indication
- Techniques
- Fasciotomy
- Fasciectomy
- Open
Rehab and Return to Play
Rehabilitation
- Needs to be updated
Return to Play/ Work
- Needs to be updated
Complications and Prognosis
Prognosis
- Recurrence rate is high
Complications
- Wound necrosis
- Hematoma
- Neurovascular injury
- Digital ischemia
- Infection
See Also
- Finger Pain (Main)
- Hand Pain (Main)
- Wrist Pain (Main)
- Physical Exam Hand
- Hand and Wrist Anatomy (Main)
External
- Sports Med Review Hand Pain: https://www.sportsmedreview.com/by-joint/hand/
References
- ↑ Image courtesy of https://commons.wikimedia.org, "Dupuytren's Contracture"
- ↑ https://www.orthobullets.com/hand/6058/dupuytrens-disease
Created by:
John Kiel on 2 November 2019 16:28:59
Authors:
Last edited:
16 October 2022 00:23:59
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