Dupuytren’s contracture is a change that occurs in the palm of the hand that makes one finger always bend more than the others, this disease mainly affects men, from the age of 40 and the fingers most affected are the ring and pinky. physiotherapy, but in some cases surgery may be necessary.
This contracture is benign, but can cause discomfort and discomfort in the daily life of the affected person, causing pain and difficulty opening the hand completely, in this case small nodules of fibrosis that can be felt by pressing on the area of the As they grow, the nodules of Dupuytren develop small strands that expand and cause contracture.
- This disease can be hereditary.
- Autoimmune.
- It can occur by a rheumatic process or even by the side effect of certain medications.
- Such as Gadernal.
- Usually caused by repetitive movement of hand and finger closure.
- Especially when there are vibrations.
- People with diabetes.
- Who smoke and consume excess alcohol.
- Seem to find it easier to develop these nodules.
Symptoms of Dupuytren contracture include
Diagnosis is made by your family doctor or orthopedist, even without specific tests, most of the time the disease progresses very slowly and in nearly half of cases, both hands are affected at the same time.
Treatment can be done with:
Treatment of Dupuytren contracture is done by physiotherapy, where anti-inflammatory resources such as laser or ultrasound, can be used, for example. In addition, joint mobilization and decomposition of type III collagen deposits in the fascia are essential elements of treatment, either by massage or with the use of devices such as crochet, using a technique called crochet. Manual therapy is able to provide pain relief and greater tissue flexibility, bringing greater comfort to the patient, improving their quality of life.
Surgery is especially appropriate when the contracture is greater than 30 degrees on the fingers and greater than 15 degrees in the palm of the hand, or when the nodules cause pain, in some cases surgery does not cure the disease, as it can be years old. There is a 70% chance that the disease will recur when one of the following factors occurs: male sex, onset of the disease before age 50, having both hands affected, having first-degree relatives in northern Europe, and also having affected fingers, however, surgery is still indicated as it can relieve symptoms for a long time.
After surgery, physical therapy should be resumed and a splint is often used to keep your fingers extended for 4 months, which should only be removed for personal hygiene reasons and for physical therapy, after this period your doctor may reassess and reduce your use of it. immobilization splint to use only during sleep, for another 4 months.
Another less common form of treatment is the application of an enzyme called chogenase, derived from clostridium histolyticum bacteria, directly on the affected fascia, which also gives good results.
Avoiding closing hands and fingers several times a day is a recommendation to follow, if necessary, a work stoppage or a change of zone is recommended, if this is one of the causes of the appearance or aggravation of the deformation.