Dupuytren’s contracture is named in honour of Guillaume Dupuytren, who, in 1831, made a description of the syndrome for the first time. He described its anatomical and pathological characteristics, in addition to proposing a treatment. Thus, Guillaume Dupuytren described this disease as hypertrophy or thickening of the palmar fascia.
Palmar fascia involves the muscles of the palm and consists of central, lateral, and medial portions.
What are the causes of Dupuytren´s contracture?
There are many theories about its cause, where genetics, fractures, stress, diseases such as diabetes or epilepsy, habits such as smoking or alcoholism and repeated microtraumas, seem to have a certain role. Family history, diabetes mellitus, liver disease, epilepsy, pulmonary tuberculosis, are risk factors.
This disease can occur in both women and men, being more frequent in the latter from the age of 40.
How does the disease evolve?
To better understand the pathological anatomy of this syndrome, we must know what is palmar fascia and fascial tissue. Well, fascia is a connective tissue system (similar to a cloth, located under the skin) that surrounds the entire body, continuously and in three dimensions. In the case of the hand, four fascial laminae are distinguished, the two laminae found on the palmar face being of greater interest for this disease: the deep lamina that covers the interosseous musculature and the superficial lamina, which thickens in its path, half forming the palmar fascia, in turn, attached to the superficial layer of the skin.
When we find restrictions in the palmar fascia that last over time, the skin of the hand begins to thicken and retract, forming fibrous proliferation, first in the form of nodules and then cords, which will gradually produce the flexion deformity of the fingers. The 4th finger is the most affected followed by the 5th, which will gradually limit the manipulative capabilities of the hand.
What can I do if I have Dupuytren´s contracture?
The disease progresses at an unpredictable speed. Physiotherapy treatment in initial stages (where myofascial induction, among other techniques, is of great interest to help slow the progression of contracture).
Physiotherapy is also useful after surgery in more advanced stages (when posing the hand on the table the palm is no longer in contact with it). It would try to return the manipulative functionality to the hand, gaining strength and mobility, keeping both the skin and the scars in the best possible condition.
You might also want to read: What are the treatment options for Dupuytren’s contracture?
At Harley Street Hospital, we have some of the best specialists to diagnose and treat Dupuytren´s contracture. Book an appointment to get a checkup.
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