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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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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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Trigger Finger Surgery

If you are likely to put severe stress on your hands on a daily basis then you might be prone to a condition which is called trigger finger. Basically, trigger finger is a condition that affects the fingers, specifically, the tendons that connect the fingers to the muscles of the hands. And individual with this condition is likely to experience some pain when moving the finger, this may happen in any five fingers. It will first cause numbness, swollenness and pain on the affected finger, as the condition is left untreated and continues to develop, there will be instances that the finger will be locked in a bent position. The affected individual may have difficulty in straightening the affected finger. In early stages, the lock will not last long and will be of a few seconds or moments, but if still continuously left untreated and the affected individual continues to perform severe activities that may cause stress and trauma to the hand and fingers, the individual will soon experience longer cases of locking. Furthermore, the finger may impose severe amount of pain upon movement.

The reason behind trigger finger lies beneath the tendons itself, our fingers our basically muscle-less meaning it depends on other muscles for its motor motions. The muscles that can be found in the hands and also in the forearms are mainly responsible for its motion, these are connected to the fingers with the structure called tendons, these are the string muscle like structure that are mainly responsible for the flexing and stretching of the fingers themselves. In short, the motion of the fingers are very dependent on the tendons, when the tendons are damaged, the finger’s movements are either eliminated or affected. In the event of a trigger finger, it mainly affects the tendons. The structures of the tendons include the tendons itself, covered by thin protective sheath and along the sheath, are lined with a structure called tenosynovium. The tenosynovium is a main structure of the tendon that is the key responsible in producing a lubricant that enables the smooth gliding of the tendon and the sheath itself. When the tenosynovium is inflamed, its capabilities to produce the lubricant is lessened or depleted, in this case, the lack of lubricant between the tendon and the sheath tend to result to a hard movement resulting in the lock of the finger during a trigger finger condition.

Trigger finger is a very treatable condition that can be cured in a number of ways. In earlier cases, this can be still treated through a non-surgical manner. Stopping all stressful activities that may affect the hands to give the inflammation some time to heal and recover. This can also be facilitated by a non-steroid anti-inflammatory drug like ibuprofen. Other than that, the use of a finger orthosis can be used in more developed cases, this will help stop the movement of the finger. The duration of how long the brace can be worn is usually prescribed by a doctor, depending on the severity of the condition. For some more developed cases, the use of stronger anti-inflammatory drugs like corticosteroid injections, which are steroid based shots, are used when the inflammation are already too severe. But in the cases of prolonged locks and pain during minor movements, trigger finger surgery is recommended.

The surgery mainly concentrates on removing the sheath that is constricting the movement of the tendon. There are two types, an open surgery release and a percutaneous release. By far, an open surgery is the most effective between the two but is more prone to complications and leaves a large scar. Basically, the process includes the application of an anesthetic on the affected finger, an open wound will then be done and removing the sheath. A percutaneous release, on the other hand, will no longer require the process of incision. It will require the use of a single needle that will be inserted on the affected area. This needle will then be used to separate the ligament that is constricting the tendon. This process takes place with the use of micro punctures. There would be no large scars left but is a very dangerous process. Neighboring the tendons are nerves that may be affected or damaged when not accurately performed

Trigger Finger Surgery

The treatment of a trigger finger does not end with the surgery itself. There are still precautions and a recovery process. The wound from the surgery will heal in a few days with a maximum of a week. Full movement will be back after a two-week period. Sports may be allowable after the first two weeks, but manual labor or more stressful sports like baseball, it is necessary to wait for a three week period. Patients who have undergone more than one simultaneous finger release surgery are more likely to have a longer healing period. In cases that the hands have been in severe conditions that led to stiffening of the fingers before the surgery, it is recommended that physical therapy may be applied to be able to improve the range of movement. Physiotherapy includes massage and minor finger movements, and occupational therapy, having a therapist to support you every day work to slowly help the hands development.

Surgery is not all of a safe procedure. There may be complications that would result. Minor complications like infection, pain and swelling that will heal over time. But there are cases that result in nerve damage causing lack of sensation in certain areas and are permanent effects. Tendons are placed in wrong positions also called as tendon bowstringing. Other than that, there is a small chance that the surgery is not at all effective, in an estimated of 3 percent of the cases, the trigger finger comes back.

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Treatment for Trigger Finger

As contrary to popular belief, the fingers are one of the most unique type of biological body structure because unlike other structures, the hands are the most developed, being able to perform any type of motor movement. What’s rather more bizarre is the unknown fact that fingers do not actually contain muscles. They are the only boned moving body structure that does not contain muscles, other than being unique, this fact makes our fingers also fragile. Because of the reason that fingers do not have muscles, their motor movement solely relies on the muscles that can be found in the hands and two long muscles that stretch to the forehand. The concept of motion within our hands is as simple as a puppet show. The bones in the fingers are connected to the muscles of the hands and wrist through string-like structures that are mainly responsible for the motion of the fingers. This is called tendons. Tendons are thin string like structures that are the ones that pull and give the fingers its motor motions, allowing the fingers to flex, stretch and move. They are the strings of a puppet, but like any puppet show, anything that happens with the strings, the puppets will no longer move. The same in fingers when the tendons are damaged, the finger’s capabilities is be either minimized or eliminated.

Treatment for Trigger Finger

A type of inflammation of the tendons in the hands is called trigger finger. Basically, trigger finger is named after the motion done when using a gun. In trigger finger, any finger affected may be locked in a bent position and after some time or struggle will directly pop back in a straight position. This condition affects the tendons in the fingers, what basically happens is that, tendons are thin strands of muscle like properties, the tendons are covered with a sheath like structure and in this sheath like structure is also lined again with another structure called the tenosynovium. This is the one responsible for producing a lubricant which allows tendons and the surrounding sheath to slide smoothly. In the case of trigger finger, the tenosynovium is enflamed causing the lack of production of lubricant, resulting in the inability of the tendons to simply slide through the sheath.

There are a number of reasons that causes trigger finger, namely strenuous activities using the hands may cause the tendons to be damaged or severely over used. Manual labor, baseball and many other forms that may cause regular trauma in the hands are considered some of the reasons. Also aging is a proven cause, as the human body ages, the muscles start to degrade, same as in the tendons, the tenosynovium produces less and less lubricant as an individual gets older. It is even said to occur mostly between the ages of 40 to 60 years and are most frequent in women compared to men. Diabetes, gout and arthritis are also seen as developmental causes of trigger finger. When an individual starts to feel the symptoms like a clicking or snapping sensation when the finger is bent, or pain and numbness on the joints of the fingers, it is likely necessary to seek treatment for trigger finger before the condition gets any worse.

There are a number of treatments used to control or cure trigger finger. Abstinence is a seen way to slowly recover from the injury, stopping all activities that may cause trauma to the hands, like strong gripping. This will help the inflammation to gradually heal and let the tendons recover. Some people who are not required to take surgery take non-steroidal anti-inflammatory drugs. Splinting is a method which is acclaimed to be effective for over 70 percent who have undergone the treatment. This will require the use of splint or a finger orthosis which is a type of brace that will be placed on the finger. This will prevent the finger to perform any type of motion, reducing the inflammation. The amount of time that an individual may be required to wear an orthosis depends on the doctor’s prescription which is also based on the severity of the condition. In even severe conditions, the need of corticosteroid injections may be necessary. This is an anti-inflammatory drug that will be injected to the tendons. Side effects may include slight elevation in the glucose levels of an individual. This might not be that severe but may be damaging to some diabetic patients, slight discoloration of the skin and twitching of the fingers.

The famous type of treatment known are the surgeries, there are basically two types. All of which concentrate in the idea of removing the thickened ligament or separating the sheath and tendon. The open surgery is considered as the most effective, though it is more prone to complications. Anesthetics is applied and an incision is made to remove a thickened ligament that limits the movement of the fingers, also in other terms, the removing the sheath that is constricting the tendon. The end result usually of an open surgery is a large scar. The percutaneous release surgery may not lead to a large scar and is less likely to have any complications, the process includes the use of a needle which will be used to pierce through the skin and separate the ligament through a micro incision. This process though is very dangerous. It may damage neighboring nerves close to the tendon.

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