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DUPUYTRENS DISEASE











Prof.Dr. Mehmet DEMİRTAŞ




Dupuytrens Disease?

Dupuytren's Contracture is a disease of the skin and subcutaneous tissue of the palm. The skin and subcutaneous tissue, which take the form of a thick and hard tissue, pull the fingers inward and restrict the movements of the hand. It usually occurs in middle age. Although it is more common in diabetics and heavy workers who use their hands a lot, the cause is unknown.

What is Dupuytren's Contracture?

Dupuytren's contracture is the stiffness that occurs in the finger joints of the hand and the inability to open the fingers. This disease is rare, but it is a connective tissue disorder. A hardened nodule forms with the thickening and shortening of the fibrous tissue under the skin of the palm. Subsequently, a very hardened tissue band is seen here. Therefore, the affected finger begins to pull towards the palm for a few months or longer. Then it remains in a fixed position and cannot be pulled back. It has been observed that it is usually seen in the 4th or 5th fingers.

What Causes Dupuytren's Contracture?

People with this disease wonder about the risk factors for Dupuytren's contracture and why it occurs. However, no clear cause has been found for this disease. However, it can be said that people with certain diseases have risk factors. For example, the risk increases in diseases such as liver disease such as cirrhosis, diabetes, thyroid, epilepsy, etc. In addition to these, it can be said that genetic predisposition is also the cause. It is usually observed in men aged 40 and over. It is also frequently seen in Northern Europeans in terms of location.

Dupuytren's Contracture Symptoms

Dupuytren's contracture has a visual appearance in the form of the fingers being pulled towards the palm. The most common symptoms are as follows:

  • A hard swelling and pitting are observed in the palm.
  • Thick cords may form in the palm of the affected finger. These cords cause the fingers to bend and retract.
  • This disease is usually not accompanied by pain. Patients notice this by not being able to place their hand flat on the floor.
  • The person cannot use their fingers comfortably. For example, they have difficulty in activities such as putting their hand in their pocket, shaking hands, and washing their hands.
Diagnosis:?

The diagnosis of the disease is made by complaints and examination.

The treatment is surgery. The surgery is performed with general anesthesia or local anesthesia on the arm. The hard and thickened subcutaneous and skin tissue of the hand must be opened thinly while protecting the veins and nerves. Recovery usually occurs after 2-3 weeks.

Dupuytren's Contracture Treatment

In the treatment of Dupuytren's contracture, patients with a mild course are only observed. However, for patients whose condition has progressed, the treatment option is surgery. In the surgery, the hardened band is removed and finger movement is regained. The operated hand of the patient is kept in a half cast, which we call a splint, for approximately 3 weeks after the surgery. After 3 weeks, the splint is removed, the stitches are removed and they are directed to physical therapy.