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Dupuytren’s disease

Dupuytren’s disease, also known as Dupuytren’s contracture, is a condition that affects the hand and fingers. It is characterized by the gradual thickening and tightening of the connective tissue beneath the skin of the palm and fingers. This thickening forms nodules or cords that can eventually cause the affected fingers to bend inward towards the palm, making it difficult to straighten them.

The exact cause of Dupuytren’s disease is unknown, but it is believed to involve a combination of genetic and environmental factors. It tends to run in families and is more common in individuals of Northern European descent (‘Vikings disease’).

It typically affects people over the age of 50, and men are more likely to be affected than women.

The initial symptoms of Dupuytren’s disease may include the development of small, painless nodules or lumps in the palm of the hand. Over time, these nodules can develop into thickened cords of tissue that extend into the fingers. As the disease progresses, the cords can tighten, causing the affected fingers to be pulled toward the palm. This can result in a loss of finger function and difficulty performing daily activities that require gripping or extending the fingers.

Treatment for Dupuytren’s disease depends on the severity of symptoms and the impact on hand function. In mild cases, no treatment may be necessary, and regular monitoring may be recommended. However, if the condition progresses and interferes with hand function, treatment options may include:

1. Needle aponeurotomy: This is a minimally invasive procedure where a needle is inserted into the affected tissue to break up the cords and allow for improved finger movement.

2. Collagenase injection: An enzyme called collagenase is injected into the cord to weaken and break it down, allowing for improved finger extension. Although it has been used extensively in U.S. and Europe over the last decade, recent literature results suggest that this method of treatment may not be as successful as it was initially thought to be.

3. Surgery: In more severe cases, surgery may be necessary to remove the affected tissue and release the contracted fingers. This is typically done under general or local anaesthesia depending on the extent of the disease.

4. Radiation therapy: In some cases, low-dose radiation therapy may be used to slow the progression of the disease and reduce symptoms.

Rehabilitation and hand therapy after treatment are often recommended to help restore hand function and mobility.

It’s important to note that Dupuytren’s disease is a chronic condition, and while treatment can help manage symptoms and improve hand function, it may not cure the disease entirely. Regular follow-up with a healthcare professional is generally advised.

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