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Gently and Surely: Finger Contracture Release 101

Fingers bend forwards, onto the palms. It can be just the ring, or the little finger. Yet worst, it can be both or more!

Dupuytren’s disease is a deformity of the hands, characterized by the fingers flexed towards the palm and the inability to straighten it. But this disease is just one of the many contracture disorders. As the fingers are composed with small joints with a complex arrangement of bones, ligaments, tissues and tendons that enable movement and stability, any type of fractures, injuries and even a small amount of swelling and scar formation, just like in Dupuytren’s disease or any disruption on this arrangement, can block a joint motion leading to contracture.

How does a contracture resolved? Or simply, how is a finger contracture release done? Since a contracture can be caused by a variety of reasons, then the treatment shall be cause specific too! For patient with Dupuytren’s disease, finger contracture release is not the first step. A doctor must first confirm the diagnosis through a table top test. A person who is unable to place his hand completely flat on the table is positive. Further imaging studies are then conducted and a detailed medical history is taken to assess the severity of the condition.

Oftentimes, conservative treatment is the first choice, which includes progressive splinting to stretch the blocking cord, steroid injection and enzyme injection, both to puncture the cord. Yes, these procedures are less invasive, but recurrence is highly possible and aggravating. Thus, when table top test is positive and the hand ability is greatly affected such as trouble in grasping or putting objects in the pocket, finger contracture release through surgery is then advised.

Gently and Surely: Finger Contracture Release 101

In Dupuytren’s disease, the palmar fascia tightens, causing the fingers to bend inwards. Why does it tighten in the first place? Research says it is autoimmunity – body cells attacking our own cells, and scar tissue forms, creating a cord into the fascia. This cord or nodule gets larger, and its hold to the fascia gets tighter. Once the grip becomes so unbearable, intolerable, and life-impacting, finger contracture release should be done. Thus, the aim of the surgery is to remove the unhealthy fascia, untie the grip, unfasten the hold, and ultimately allowing the fingers to straighten out again. In some cases, skin grafting in the area close to the incision gives the finger more freedom and flexibility to extend or straighten.

During the actual surgery, an incision shall be created on the skin. Once the affected palmar fascia is seen, it is then carefully separated from the nerves, arteries, and tendons. Extra precautions are taken with utmost care so that the nearby nerves and blood vessels will not be damaged. Gently yet surely, the surgeon shall then remove enough of the palmar fascia to straighten the finger/s. Once the diseased tissues are removed, the skin is sewn together with fine stitches.

After surgery, your hand shall be bandaged with a sufficiently-padded dressing and a cushioned splint. This shall keep the hand in neutral position, and the fingers straight, ready for healing. Five to seven days after, your surgeon shall re-examine your hand and after 2 weeks, some stitches shall be removed. Since lots of nerves are found in the hand, discomforts may appear after surgery. Pain medications are given to control or relieve the temporary pain. Post-op patients are also advised to keep their operated hand elevated to avoid further throbbing and swelling, with a stack of pillows when sleeping of sitting up.

Although rare, complications might occur after surgery such as nerve and blood vessel injury, and infection. Thus, following-up with the doctor is very important to ensure that you are healing well and finger contracture release has been done gently, surely and successfully.

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Remedies for Blue Joints in Fingers

Blue joints in fingers could be an effect of several things which may include aging, low levels of antioxidants, plain abuse and overuse. Downright abuse and age are the top reasons why there is pain in the finger joints.

Fortunately, there are a few easy ways which could be done to treat blue joints in fingers as well as in all other joints within the body. Two of the most used treatments are overnight and long-term solutions.

Overnight Blue Joints in Fingers Remedy

Until today, Castor oil is still amongst the most famous solutions for all types of health problems. Castor oil possesses the ability to remove any foreign matter or growth that does not belong to the body naturally. These foreign growths could be in the form of calcium buildup and bone spurs which may be the cause of pain in the joints.

While Castor oils have many beneficial components, these also have drawbacks like being gooey, thick and do not penetrate easily on the skin. This is the reason why a lot of individuals make use of heating pads in putting castor oil on their fingers; to facilitate the absorption of oil on the skin.

However, heating pads actually are awkward to use around the fingers. Hence, a rubber, latex or cotton gloves could help in making the application easier. In order to alleviate the pain the fingers, you can follow these steps:

  • Rub the castor oil on your hands and fingers, most especially. To achieve the best possible results, you can do the castor oil application at night before going to bed.
  • Put your cotton, rubber and latex gloves on. Wipe excess oils outside your gloves.
  • Sleep with your gloves on.
  • Remove your gloves in the morning. To be able to remove the oil on your skin thoroughly, make a paste out of mixing water and baking soda then apply on your skin.

Repeat this procedure daily within a month. When this is religiously followed, you will be able to realize that pain has been significantly decreased. Another great option is to incorporate some mixes of DMSO. This will act like water and baking soda paste since it also takes away all traces of castor oil in your hands. DMSO could be bought in almost all feed stores; however, a few hardware stores offer them also.

Long-term Blue Joints in Fingers Remedy

The term “antioxidant” is so popular today that most people think they know what it means. A good number of people would say that “antioxidants” are great supplements to health. However, they do not know how they function inside the body. To put it to simple words, antioxidants are both beneficial and nutritional substances which protect the cells from possible damages. Antioxidants protect the body against reactive and unstable molecules referred to as radicals. When free radicals are within the body, they could:

  • Interfere with the body’s metabolic functions
  • Damage the body’s cells and tissues
  • Speed up a person’s normal aging process
  • Allow diseases and infections to get inside the body

Aside from protecting the body against the effects of the actions of free radicals, these antioxidants also provide lubrication within the body such as in joints of fingers. Taking antioxidants could also help in restoring the health of damaged joints. A few good antioxidant choices are:

Remedies for Blue Joints in Fingers
  • Blue green algae
  • Concentrated wheat sprouts
  • Coenzyme Q10

While blue green algae and coenzyme Q10 could be taken as maintenance medications, it is best to have wheat sprouts for blue joints in fingers. This is because, wheat sprouts have a strong cleansing and detoxifying effect; thus, relieving inflammation and pain.

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Contractures of Fingers

Dupuytren’s contracture is a very famous disease that targets the fingers. Men can acquire the disease more than women as studies reveal. The disease is hereditary and can therefore be passed on the family line through the generations. It’s also more frequent to people within the ages of 50 to 60. Capsular contracture treatment will depend on the severity of the condition of the patient.

Causes of the Disease

Though the exact cause of the disease hasn’t been discovered yet, there are some factors that have been known to increase the risks of getting the disease. Dupuytren’s contracture has been discovered to be rampant in people who had epilepsy for quite some time. A number of doctors believe that such risks may have been triggered by anticonvulsant medications which epileptic people take.

Factors that Contribute to the Occurrence of the Disease

Smoking and drinking have also been associated to the disease. People who have type 2 or type 1 diabetes also have the tendency to develop lumps on the tissues of their hands and palms although they usually don’t get contracted fingers. Dupuytren’s contracture makes mundane activities more complicated. Such activities are shaking hands or putting on gloves. The disease also tends to be more common to whites with ancestors living in Northern Europe. The condition is rare for people with color. The disease commonly affects both hands although one hand would be worse than the other.

How the Disease Can Affect Individuals

Dupuytren’s contracture is generally painless and usually doesn’t interfere while individuals are doing ordinary, everyday tasks that do not involve the use of the hands. Since the index finger and thumb aren’t affected, a lot of people aren’t really that helpless with contractures of fingers. The small and ring fingers are more affected than the other fingers though many of the digits may be affected as well.

Dupuytren’s contracture rarely causes trauma, but bumps of tissues over the palms can be sensitive to touch. Dupuytren’s contracture basically starts with the thickening of the palm. In later stages, the disease develops cords of tissues beneath the rind of the palms. Cords may go up to the fingers. As the cords tighten, the fingers are pulled to your palms and severely at times.

How Dupuytren’s Contracture Develop

Dupuytren’s contracture generally develops slowly over the years. Sometimes, it can progress for weeks and months. As the disease progresses, the skin over your hand’s palms may seem dimpled. In other people, it may develop more quickly but then begin to stop. But the disease never ceases to reappear.

Treatment for Dupuytren Contracture

The disease isn’t really harmful but can be quite inconvenient to you. Treatment for Dupuytren’s disease using vitality x-rays may treat the disease for a long period of time especially when it is done during the earlier stages. Should a painful lump be found, an injection can help eliminate the pain. Surgery may be necessary if your fingers fail to straighten up or don’t function well.

Surgery in Dupuytren’s contracture may involve the removal or division of thickened bands to restore the finger’s movements. Risks during surgery may include injuring the blood vessels and nerves, and infection. Some soreness and swelling could develop but serious problems are very rare. What’s troublesome about the condition is the affliction it causes to individuals who aren’t able to use their fingers because of the disease.

Raising your hand after surgery and slowly moving the fingers will help minimize swelling, pain and stiffness. Surgery will not always treat the condition as it may come back or recur in time. But surgery can mend the effects and enable you to enjoy the normal functionality of your fingers for quite some time.

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Dupuytren Disease Treatment

Dupuytren’s disease is a condition whose cause is uncertain. The condition is manifested by a hard lump of skin that usually forms on the fingers. The connective tissue accumulates over the palms of both hands although one hand may be more affected than the other. The disease begins with a local accumulation but then spreads to other parts of the body as it develops in the later years. The disease is usually observed to affect the middle and ring fingers although the index finger may be affected as well. Dupuytren disease treatment can be administered to individuals with severe cases of the disease.

Theories on the Cause of Dupuytren’s Disease

Dupuytren Disease Treatment

Many researchers are now thinking that the lump of connective tissue is the product of the medications taken by epileptic patients. Such medications, as they observe, make the individual more vulnerable to having Dupuytren’s disease. Epileptic medications increase the production of components that trigger the formation of the condition.

Age also seems to be a significant factor because people aged 30 to 40 seem to be more susceptible to the disease than other age groups. If certain areas of the hands such as the palms and fingers are affected, it will be difficult for the individual to move his fingers or use them.

Causes and Mechanisms of the Disease

There are several theories as to what causes the disease but all of the theories are still inconclusive. It has also been observed that the condition develops gradually over time. It’s very difficult to determine its symptoms because the whole development is painless. The most obvious symptom is the inability to move your fingers properly.

The tissue itself is non-cancerous and usually non-traumatic. The connective tissue grows over and under the skin of the palms, affecting some of the tendons along these areas. It will be difficult for the patient to do certain tasks with the hand like holding a glass of water in place or grabbing something out of his pocket. These are some of the worst cases. The connective tissue is sensitive but it would be painless.

Painless but Troublesome Condition

Individuals with Dupuytren’s disease seek medical attention not because of pain but because of the difficulty to do basic chores using the hands. Because the cause of the condition and its accumulation isn’t well understood, physicians have to try and treat the disease empirically. Surgery though, is one of the most effective treatments used under such circumstances.

Therapy May be Used

Dupuytren Disease Treatment

Therapy may be used to help patients become more mobile with their fingers. Oftentimes, education with regards to the disease is enough. Surgery is recommended in the long-run if cases are beyond therapy and deformities start to form. If you don’t like surgery, then your best alternative is prevention although the disease may recur from time to time and never completely eliminated.

The Goal of Treatment

It is the aim of treatment to improve the positioning of the fingers, allow it to open or close and improve the functioning of the hands. In less severe cases, where the condition is gradually developing, pain will not be felt and the functioning of the hand will not be affected. Regular assessment will still be required in the process. With severe cases however, a number of treatment options for straightening affected fingers are important. This treatment involves the breaking or removing of cords that pull your fingers to your palms.

In your initial consultation, appropriate treatments will be based on the pattern and stage of your condition and which of the joints are affected. Before commencing treatment, it is crucial to set realistic aims and talk about possible results and risks.

The Disease May Recur Even after Treatment

It is also vital to take note that permanent cure for the disease has not been discovered yet. In spite of treatment, the disease may recur in the long run. The important thing here is to maximize the functionality of your hands during the various stages of the disease.

There are various ways of straightening the fingers and releasing the contractures. Such treatment options may include minimal needling techniques like needle aponeurotomy or percutaneous needle fasciotomy, conservative measures like splinting, and open surgery or fasciectomy.

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Treatment for Contractures

There are instances that the human muscle may act weird, despite its ability to adapt and grow with the use of exercise and everyday activities. It is also capable in the process of shortening itself. There are cases that this happens resulting in the limited movement of a muscle or joint and worst cases suggest individuals who have lost total control of movement. A condition which results in the shortening of the muscle or joints is called a contracture. In this case, an individual suffering from this condition may experience a decrease in angle between joints like the arms coming closer to the body with the inability to have full control or just to have motion senses. This condition can happen in any part of the body, in the hands, arms or even legs. There are multiple other specific conditions that are related and caused by contractures like the Dupuytren’s disease which happens on the palms of hands and is caused by the shortening of a tissue that is found between the palms and the fingers. There are a number of reasons why this condition occurs.

Treatment for Contractures

Deformity, immobility, injury or chronic inflammation may be a seen cause of a contracture. Any trauma may trigger an abnormal activity within the affected joints or muscles. Other than that, there are in born causes like muscular dystrophy which is a degenerative disease of the muscles and cerebral palsy which is the impaired ability to control muscles. This condition though is not a permanent disease and can be relieved in a number of treatments.

A basic type of treatment for contractures is the physical therapy, it is much widely suggested that people who are suffering from the shortening of either muscle or joints to be more active, increasing the range of motion of the affected body parts. In this case, the shortening will be limited, lessened or controlled because of the continuous stretching that will counter act the development of the condition. Having an inactive lifestyle may only tolerate the progression of the disease without anything having to counter act its continual development. Physical therapy not only helps develop the muscles but also increases joint elasticity, counter acting the stiffening process.

Casts, splints and orthosis are also used to prevent the development of the condition. Casts in general help keep the affected joints and muscles in a more functional position. Helping to stretch and keep the joints and muscle in a non-tolerable manner. In this case, casts are usually repositioned from time to time to prevent stiffening of the muscles or joints. This usually used mostly in cases when the individual affected is unable to develop a sense of motion for himself, in short, he is immobile or have been in an accident. But there are also cases that braces are used with fully functional individuals like the Dupuytren’s disease, contracture of the hand, an orthosis is used to fully stretch the finger without the continuous effort of the affected individual. Other than manual treatment, mechanical treatment is also present, with the use of other devices to continuously manipulate the movement of muscles and ligaments, especially used after an operation to slow down the rate of shortening. There are also medications to help prevent the shortening of the muscles or tendons, steroid based medications primarily.

Treatment for Contractures

When all else fails, when basic treatments and medications are ineffective, the last resort of treatment considered is surgery. Surgery is used in contractures that have caused damaging effects on individuals, like the inability of motion and deformation. The surgery will primarily manipulate the affected joints or muscles depending on the affected area. Its main process is to separate shortening ligaments or muscles, in the case of Dupuytren’s disease, the shortening tissue is removed.

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