Contracture of the hand, wrist and finger is caused by the shortening of connective tissues, muscles and tendons resulting to the inability of the joints to extend. A wrist contracture could be brought about by the formation of scar tissue around or in the joints. This leads to limited extension and restricted movement of a person’s wrist.
Often, finger contractures are precipitated by the disease called Dupuytren’s contractures. This disease is progressive in nature and affects the tissues under palm’s skin which is the palmar fascia. The triangular, strong and thick fascia is located in between the skin and the tendons, with attachments below and above, extending into the fingers. While the palmar fascia shortens and thickens because of the disease, the person’s fingers could gradually be pulled to the palm taking away the capability of the fingers to be straightened. The progression of this disease varies from one person to another. Also, the occurrence of symptoms could not be predicted, although, the contracture is more likely to happen when a member of your family has had this disorder. Other contributing factors would include being male, diagnosed with seizure disorders, if you are alcoholic and have undergone any hand surgery.
The symptoms are most often experienced in both of a person’s hands with the little and ring fingers being affected tremendously. The thumb and the index finger are rarely affected.
Causes of Contractures:
- Hand Injury or Surgery: These form scar tissues especially during the recovery process. If the scarring happens within a position that affects the normal movement of a person’s finger joints, contractures could result.
- Family History: The finger contracture causes are unclear. However, there is a 65%-70% chance that this could be brought about by a history of the condition within the family.
- Other causes: The following factors have not established a strong connection to the finger contracture disorder, although, these increase a person’s risk of having it. These are: liver disease, epilepsy, alcoholism, diabetes, Viking and North European Ancestry, smoking, being male and senior citizen.
The initial symptoms are tiny nodules within the hand most especially in the palm near the fingers. These might be painful in the beginning; however, pain disappears with time. The person may start to pucker and the palm’s painless cords could extend towards the fingers. In trying to extend the fingers, the skin may blanch and it could lose color. The range of motion could be restricted and the normal ability of the hand to function properly may be reduced.
Today, there are already two options for treating finger contractures. The outcome of each of these options will depend mainly on the maturity of the scar tissue. If the finger contracture occurred just recently, the best method to correct the disorder is to wear a splint on your wrist together with a few other hand exercises to improve your range of motion.
On the other hand, when the scar tissues are more than 3 months old, improving your range of motion is impossible already; hence, surgery is your best option. The purpose of surgeries will be to get rid of the scar tissues to be able to loosen up the finger joints, even if it could not be removed entirely and newer scar tissues have piled up on top of the older layers. After the operation, a splint should be worn for at least 6 weeks. The use of the splint should be gradually reduced as hand stretching exercises are introduced.
For Dupuytren’s disorder, the main treatment will be composed of a “wait and see” scheme. This is because before the any medical procedure is done, an observation is recommended to be able to determine the extent of damage. In a few cases, early treatment provides the patients hope that the disease is still manageable.
Aponeurotomy is the procedure most often utilized to separate finger cords; hence, restore mobility. This can be performed under an outpatient registration. This treatment method is preferred by many because this is not as invasive as others and scar tissue formation is lessened. Recuperation care will include using a splint for a specific number of hours each day.
After a surgery, recurrence is still possible, rehabilitation could be lengthy and complications might happen.