Educational video describing the condition known as Dupuytren's Contracture.
Dupuytren's Contracture is a condition of painless thickening of the tissues in the palm of the hand and fingers. The condition causes contractures or tightening of the tissues in the hand causing the fingers to become bent down and function of the hand is impaired.
The fingers curl up and the patient is unable to straighten them. Usually affects males older than 40 years old and of European decent. It usually affects the ring and little finger.
Rick factors
•Alcoholism
•Epilepsy
•Diabetes
•Liver disease
•Hereditary in some patients
Symptoms
•Unable to straighten the fingers
•Cordlike band in the palm
•Deformity develops slowly and rarely affects the distal interphalangeal joint.
•Bilateral in 50% of patients.
Tests and diagnosis
Tabletop test
•The tabletop test is a simple maneuver that can determine if there is a contracture in the hand.
•By laying the hand palm down on a tabletop the patient attempts to flatten the hand.
•Being able to flatten the hand means that no contracture is present.
Treatment
•Splinting
•Injection
•Surgery: surgery can be needling. Cut the cord or excise the cord.
When do you do surgery?
Indication for surgery occurs when the MP joint is in 2030 degrees of flexion contracture or any degree of PIP flexion contracture.
Who will have a bad prognosis?
The disease is aggressive and may reoccur.
•Young patients
•Bilateral
•Hereditary
•Involvement of the radial digits