Dupuytren’s contracture – curled fingers

Curled fingers

Getting its name for French surgeon Dupuytren in 1831, this condition is a progressive disease of connective tissue. The most common localization of the disease appears in the area of the fist as an isolated phenomenon. Sometimes, however, changes appear on the bottom side of the foot or in the genital area. Characteristic symptoms include “bumps” and “tapes” on the palm, that increase over time and lead to increased curling of the fingers; the so called flexile finger contractures. This process is basically the proliferation of the connective tissue, through which the skin becomes harder and immobile because of the lack of subcutaneous fat tissue.

The patient observes progressive “curling” of the fingers at the level of two rows of joints of the small finger, ring and middle finger. The strength of the hand is diminishing, everyday activities become increasingly difficult as deformities progress. In the area of the palm, thickening occurs. Changes in connective tissue in the genital area also create discomfort.

Diagnostic

Usually, its the IV and V finger that are affected. Most male patients are between 40 and 60 years of age. It often occurs in diabetics, people with HIV infection or hyperlipidemia. Both hands are frequently affected by this disease which limits the patient in performing daily activities.

Treatment

Initially, the contracture can be treated by applying corticosteroid injections to the thickening area. Several applications are commonly required, leading to a certain reduction in the changes.

Thanks to the increasingly frequent use of autologous conditioned plasma, the results of such treatment are more than promising. Even after a couple of injections, there is softening and reduction of thickening in the area of the palm. The method is completely safe and painless, and is run by specialized Polyclinics staff at very affordable prices.

Today, collagenase enzyme injections are offered, whose application leads to the regression of present thickening on the palms. This type of therapy still has a steep price on our market.

There are several levels of this illness. If progression is present, surgical treatment should be applied instead.

Operative treatment consists of so called. partial or radical fasciectomy, which is used to remove fewer or more diseased tissues. Unfortunately, there are also some cases where amputation of the bent finger is the only solution.

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