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Dupuytrens Contracture

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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


Differential Diagnosis


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

Evaluation

  • Primarily a clinical diagnosis

Radiographs


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


References


Created by:
John Kiel on 2 November 2019 16:28:59
Authors:
Last edited:
13 April 2022 17:06:28
Categories: