Tag Archives | hand contracture

Dupuytren’s Disease Symptoms

The role of the hand in our lives is very vital in maintaining a normal way of living. If anything happens to our hands, there will be a decrease in our daily productivity. A multitude of disease may hit our hands. It could come from viruses or bacteria, and also there are the common tissue disorders. One of the hand diseases that affect both the palm and the finger is the disease known as the hand contractures or the Dupuytren’s disease. This is a type of disease that slowly causes the tightening of tissues found underneath the skin of the palm and fingers. Because of the tightening, this will result in the bending of fingers towards the palms, not allowing an individual to fully stretch their fingers on the long run, or more severely, not allowing the fingers to move. Dupuytren’s disease, as of the moment, is known to be a disease that is inherited. There are medical remedies like injecting cortisone to prevent further tightening of the tissues. There are also surgeries that will help treat individuals with a much more severe case. The easiest way to prevent resolving this disease through surgery is by knowing the early developmental stages and learning Dupuytren’s disease symptoms.

Dupuytren’s Disease Symptoms

Dupuytren’s disease is a naturally occurring disease under the skin, through the start of its development and in its early stages, pain is not a symptom. Moreover, there are no recognizable symptoms in the first stages of tightening. But later on, there are visible marks and changes on the hand. The earliest visible symptom is the recognizable abnormal thickening of the skin, it can be said that it is an abnormal growth when the thickness of the skin is not equal along the rest of the palm. The thickening can be seen near the ring finger and pinky. After a time, recognizable dimples will develop and can be seen. If still left untreated, the skin will continually harden and will result in a much larger clump of skin on the palm. The skin, in turn, will start to become very sensitive to the touch but not actually painful. The symptoms will get worse. The lump will eventually grow larger and harder. In severe cases, a tendon like form can be seen. It is then recognizable to be unable to fully stretch the fingers. Later on, the fingers will be visibly closer to the palm and can no longer be fully straightened. In this case, the disease has reached its middle stages and must be checked by a specialist before the hand may lose its capability of moving.

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Hand Contractures Treatment

Try to flex your fingers as hard as you can, if you have problem or difficulty in achieving a full stretch, your fingers to be fully straight, and then you might be suffering from a disorder commonly known as hand contractures, in other terms known as Dupuytren’s disease. Hand contractures usually happen with the pinky and the ring finger. The middle finger sometimes is affected but the thumb and the pointer finger are spared most of the time. This condition might be irritating and later on will cause problems. In the long run, the fingers will eventually come closer to the palm and would result to uselessness of the hand itself.

Causes and Origin

This disease is known to affect the tissues that are found under the skin of the palm. Later on, these tissues tighten and will cause the fingers to move closer to the palm. Through recent studies and research, there is not much known cause or origin of this disease but it might run along the gene. Research states that people with hand contractures had them in their bloodline, but other than that, trauma is a possible cause also. According to recent studies, it has been seen that there are signs of minor bleeding within the tissue affected symbolizing trauma. This trauma is may be caused by hard labor. This disease is usually seen in aging males and is not likely in females. But there are cases of younger individuals who suffer from the disease itself, there are Hand Contractures Treatment to help lessen the development, or to actually cure the disease.

Hand Contractures Treatment

Different Treatments

In the early stages of hand contracture, when symptoms start to develop, cortisone injections are the usual treatment. With the use of the injections, the tightening of the tissues is either lessened or stopped. But in worse cases in which there are recognizable effects like inability to move the pinky or the ring finger, surgery is the most applicable treatment that can be done. There are two ways in treating severe case hand contractures, the common and the earliest form is through the process of an open surgery. In this process, large cuts are made on the palm and also on the affected fingers. The contracted or contracting tissues are then removed. The problem with this procedure is that it leaves large scars and is more likely to develop complications compared to needle aponeurotomy.

NA or needle aponeurotomy, on the other hand, is a much more delicate process in which a needle is used to separate the contracting tissue under the skin. The good side with this procedure is that this will only leave small scar marks on the hand and is less likely to develop complications compared with the open surgery.

Hand contracture will certainly redevelop itself after a period of time whether you treat it through surgery or NA, NA will cause it to come back with a time span of at least 3 years while surgery, on the other hand, is 5 years.

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Fingers Curved, Thumbs Down: Hand Contracture Causes

Imagine not able to grasp, grip, hold or even perform a high five? Yes, hand contracture can be as horrible as not being able to do anything – with your hands. Aside from these inabilities, social stigma may rise because of the bizarre hand flexion. What are hand contracture causes and what are the chances that we can have them treated?

A contracture is the shortening of particular tendons, muscles or other connective tissue, resulting to the inability to fully extend or straighten affected joints. Hand and finger contractures are often related to Dupuytren’s contracture. Usually develops over the years, this disorder affects a layer or bundle of tissues under the skin of your palm. Abnormally, these tissues mutate and change and form a tick cord the can pull one or more of your fingers and making it bent. Once this happens, the affected fingers cannot be fully straightened which can be very evident when you place your hands on your pocket, put on gloves or even when you shake your hand.

Fingers Curved, Thumbs Down: Hand Contracture Causes

The exact cause is unknown. But most researchers conclude that it can be associated with an autoimmune reaction – atypically, a person’s immune system attacks its self, tissues and creates a cord. Various factors are also associated with the contracture that increases one’s risk of having it. People aging 40 and above are at higher incidence to acquire it, as symptoms fully occur at this age. Men are more likely to have it than women. Checking your family history about this may also help, since it runs in families, especially those of Northern European descent. Diabetes patients should also take precautions since they have increased risk. Most of all, smokers and alcoholics, must think ahead because smoking chemicals and alcohol may initiate cell mutation.

Hand contracture causes may still be unfamiliar but these risk factors keep us aware of how close we are in acquiring the disease. The last thing we would want is having those topsy-turvy fingers!

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In Focus: Palmar Fibromatosis

Our hands are man’s productivity tool. Being aware of what may inflict them is a key to protect them, just like how palmar fibromatosis affected the hands of powerful history makers, Napoleon Bonaparte and Ronald Reagan.

Palmar fibromatosis, morbus Dupuytren or simply known as Dupuytren’s disease is a hand contracture characterized by the thickening and tightening of the fibrous tissue on the palm of the hand, called the palmar fascia. This causes the bending of the fourth and oftentimes, the fifth finger, towards the direction of the palm.

The challenge with this disease is not just spelling out Dupuytren’s or palmar fibromatosis. The real issue is all about knowing what really causes its occurrence. Named after Baron Guillaume Dupuytren, the surgeon who first described the operation to correct it in 1831, the disease is still an open maze for medical scientists. Although the cause is unknown, the disease tends to run in families. This genetic predisposition is further amplified for those of Northern European descent. Legendarily believed as a disease initially inflicted by the Vikings who have conquered Europe, palmar fibromatosis is also called the Viking’s Disease. In the battle of men versus women, the disease tends to go with men’s strong claw-like hands, and usually starts at age 40 then progresses slowly. The incidence is also greater for people who have existing diseases such as diabetes mellitus, epilepsy, pulmonary disease and liver problems. Plus, alcohol drinking and smoking can augment chances of having it, too, as they increase chances of cell mutation due to lack of oxygenation.

How does palmar fibromatosis happen? Under normal conditions, strips of fibrous tissues, usually soft and pliable, lie under the skin of the palm. This is called the palmar fascia. But in people with Dupuytren’s disease, certain cellular changes occur. Thus, most researchers relate the disease to autoimmunity – our body cell becomes overactive that they attack our very own cells. This process enables scar tissue formation. These scar tissues that develop on the palmar fascia create cords or nodules which tighten and contract the connective tissue. As the palmar fascia tightens, our fingers are bent towards the palm, and cannot be straightened. The process usually starts at the crease on the palm of the hand, and progresses at the joint near the base of the finger, then to the next joint of the same finger. The ring finger is usually the first victim, followed by the little finger. The condition may appear suddenly, yet it progresses slowly that the symptoms are quite unnoticeable, until it becomes severe and life-changing.

How is palmar fibromatosis diagnosed? Simple and easy, the table top test provides the answer. How is it done? A person is instructed to place his hand completely flat on the table. Inability to do so, or existence of even a space as big as a diameter of a ball pen, shall confirm the test, as positive. To determine the gravity of the condition and the location of the nodules, the doctor shall advise the patient to undergo a series of imaging studies and a comprehensive medical history. When a contracture is mild and a person is able to do normal activities, treatment shall focus on preventing further contractures. Stretching your fingers backward from the palm or placing your fingers at the edge of the table with palms down and then lifting the palm upwards gradually is one simple home remedy. Massage with lanolin cream and application of microwavable heat packs before stretching are also helpful. Most importantly, protecting the hands by building up handles with pipe insulation or cushion tape or heavy paddings for grasping tasks prevents the occurrence of further hand injuries and deformities.

If the palmar fibromatosis progresses severely that significant hand activities are interfered, then, conservative treatments are out. Here comes the more advanced and aggressive type. Generally, this kind of treatment aims to break or remove the cords or nodules that tighten the fascia and bend the fingers. The choice of procedure still depends on how worse the case is.

In Focus: Palmar Fibromatosis

Needling technique uses a needle, inserted through the skin, and acts to puncture or break the cord of tissue tightening the finger. A non-invasive option, it can also be done on several fingers at the same time and most often, little physical therapy is needed afterwards. Yet, chances of recurrence are high.

Likewise, enzyme injections involved injecting an enzyme towards the cord to soften and weaken it. Then, the doctor shall manipulate to break the cord and straighten the finger. Almost of the same benefits with needling, enzyme injection can be more painful initially.

Surgery is still the last resort if all things fail. It allows the doctor to surgically remove the affected tissues, liberate your palmar fascia, and straighten your fingers. Although, it promises a more complete joint release, recovery time and rehabilitation after surgery may take a longer time.

Palmar fibromatosis, Dupuytren’s contracture or whatever you call it, this hand-inflicting disease is indeed life-impacting. Remember, our hands no matter what size or looks they have, are still worth protecting!

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