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What is Dupuytren's contracture?
Dupuytren's contracture is a hand disorder in which the fingers bend towards the palm and cannot be straightened. The little or ring fingers are most commonly affected, but any or all fingers can be involved.
Dupuytren's contracture progresses slowly and is usually painless. The disorder develops when the tissues under the skin of the palm thicken, forming knots (nodes) and cords of tissue. These cords can then shorten, pulling one or more fingers into a bent (contracted) position, which cannot be straightened.
Dupuytren's contracture is also known as Dupuytren's disease as not all people experience the contracture (bent fingers).
What are the risk factors for Dupuytren's contracture?
The exact cause of Dupuytren's contracture has not been identified. Factors that have been associated include:
- Age and sex (more common in males in their 50s and 60s)
- Family history
- Diabetes mellitus
- Epilepsy (possible association with anticonvulsant medications but this association remains controversial)
- Hand trauma
While the role of occupation is still debated, there is some research that indicates that heavy manual work and vibration exposure may be associated with Dupuytren's contracture. Other studies do not show this association.
How is Dupuytren's Contracture treated?
There is currently no cure for Dupuytren's contracture. Often no treatment is required. Some methods have been investigated for the treatment of Dupuytren's contracture where the disorder is painful or interferes with the use of the hand. These include among others, medications, physical therapy, fasciotomy, enzyme injections, vitamin E, radiation or ultrasound therapy, steroid injection, or collagenolytic agents. Some of these treatments have resulted in more effectiveness than others, but none have been scientifically proven yet. For an accurately diagnosed case of Dupuytren's contracture, the widely accepted treatment to date is surgery.
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