![]() ![]() Before treatment, the hand surgeon will discuss realistic goals and possible risks. The nodules and cords may come back in the same or a different location. Even with treatment, the disease is not fully curable. Complete correction of the fingers may not always happen. The goal of treatment is to improve finger motion and function. A hand surgeon (either a trained orthopaedic surgeon, plastic surgeon, or a general surgeon) can discuss the most appropriate method based upon the stage and pattern of the disease and the joints involved. These are typically discussed when the contracture prevents the hand from lying flat on a table. Splinting or stretching typically does not prevent worsening of the contracture but is safe to try.įor contractures that become bothersome, there are nonsurgical and surgical options. In mild cases, especially if hand function is good, only observation is needed. ![]() Some factors that are important in evaluating masses include their size, “feel” (such as firm or squishy), location, presence of pain, movement of mass or skin around the mass, family history, and other medical conditions that may be present. Other times, imaging such as an x-ray, ultrasound, or MRI may be indicated. ![]() Sometimes a history and examination is all that is needed to evaluate a mass. Therefore, it can be helpful to see a hand surgeon for an examination. Also, not all lumps in the palm are Dupuytren’s. The presence of a lump in the palm does not mean that treatment is required or that the disease will progress. Occasionally, the disease will cause thickening on top of the knuckles called a knuckle pad (or Garrod’s pad). Lumps and cords can develop on the soles of the feet (plantar fibromatosis) or the genital location in men (Peyronie’s disease). If there are changes in other areas of the body, you are at higher risk. If you have many relatives with the problem, you may be at higher risk for more severe disease. Men develop more severe symptoms when compared to women. The disease tends to be more severe if it occurs at an earlier age. Some people have only small lumps or cords while others will develop severely bent fingers. ![]() It is difficult to predict how the disease will progress. When it involves the right hand, people can find it awkward to shake hands. It may be more difficult to wash hands, wear gloves, hold large objects, and get hands into pockets. The disease may first be noticed due to difficulty in placing the hand flat on a surface (Figure 3) or opening the hand fully. However in most people, Dupuytren’s contracture is not typically painful. The lumps can be uncomfortable in some people. Each hand can be affected in a different pattern and at different times. The ring finger and little finger are most commonly involved. These cords may cause bending of the fingers. Thick cords may develop from the palm into one or more fingers. In other areas the skin is puckered and pulled down like a pothole. Some areas are swollen and puffy like a speed bump. Think of the Dupuytren's palm skin like a road. The lumps are generally firm and stuck to the skin of the palm. Symptoms of Dupuytren’s contracture usually include lumps, nodules, and bands or cords on the palmar side of the hands. This can become bothersome and limit use of the hand in many people. This makes it impossible to fully open the fingers (Figures 1 and 2). They may begin to pull the fingers into a bent (flexed) position so the fingers are bent toward the palm. Cords and nodules may become bigger and thicker over time. They can also have a slow or fast change. When they are first noticed, these nodules and cords may not change for a long time. Most people with Dupuytren’s contracture will also have nodules or bumps in the hand. Unlike a tendon that is moved by a muscle that shortens and lengthens, cord tissue is not connected to a muscle. These cords are often mistaken for a tendon because they look and feel similar. In Dupuytren’s disease, this fascia can become abnormal. Fascia covers the important nerves, blood vessels, muscles, and tendons. In the normal hand there is a fibrous tissue called fascia. Dupuytren’s contracture is a disorder of the palm of the hand and fingers. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |