What is Dupuytron's contracture and what are its symptoms?

Dupuytren's contracture is a progressive connective tissue disease that affects the palms and fingers. This disease causes thickening and shortening of the connective tissue under the skin, and as a result, the fingers bend towards the palm and lose their ability to fully open. This situation gradually worsens with the passage of time. Such a condition can affect your daily activities, including shaking hands, using gloves, etc. There is no cure for this disease, only a solution can be considered to control the symptoms and prevent the severity of this disease. Related content: Sore feet What is meant by Dupuytron contraction? Contraction or Dupuytron's disease is a genetic disorder that causes thickening and hardening of the tissue under the skin of the palms and fingers. In this disease, small nodules develop on the fascia of the hand, the elastic tissue that supports the hand and fingers. Over time, these knots may become thick strands and cause the fingers to bend so that they can no longer be straightened. The growth of these abnormal tissues is always benign and has nothing to do with cancer. Some cases may require surgery; But in many patients, conservative treatment methods can control the condition What people get this condition? Dupuytron's contracture can affect anyone; But some people are more susceptible: - Gentlemen - People with a family history of this disease Relationship of Dupuytron's contracture with other diseases Some diseases and medical conditions that can increase the chance of developing Dupuytron are as follows: - Diabetes - Epilepsy and other convulsive disorders - alcohol addiction - HIV and AIDS - Vascular diseases What effect does this disease have on your body? Dupeytron contraction may not have any visible effects on your body. If the symptoms are mild, you may not notice this disease. Even if symptoms do occur, they usually progress very slowly and may take months or years to become severe. In advanced stages, it may be difficult or even impossible to straighten the affected fingers. This disease can affect any of the fingers, including the thumb; But the possibility of finger involvement is higher in the following order: - ring finger - little finger - middle finger - index finger - Thumbs Read more: Causes of finger pain Can this complication affect other parts of the body? Dupuytron's contracture is visible only on the hands and does not occur in other parts of the body. Although this disease is related to some other connective tissue disorders; But it can only be seen in the hands. What are the symptoms? Dupuytron's contracture usually progresses gradually over months or even years, so you may not notice any symptoms at first. The symptoms of this disease appear as follows: ### Small nodes or nodules The first sign of this disease is the formation of small bumps under the skin of the palm, which is usually located at the junction of the fingers with the palm. These nodes may be palpable or visible. In some people, these nodes remain the only symptoms of this disease and may even resolve on their own. Sometimes the skin around this area looks sunken or wrinkled. ### textured strips Over time, the knots thicken and become strands of tissue in the fascia. These strips can pull the fingers inward and create a feeling of stiffness or stretching in the hand. ### contraction In advanced stages, tissue bands become so thick and hard that it is no longer possible to straighten the fingers. This stage of permanent bending of the fingers towards the palm occurs. Unlike some diseases, Dupuytron's contracture usually does not have a specific stimulus that causes the symptoms to worsen; But over time, these symptoms may slowly worsen. However, some people do not pass the early stages of the disease and will not progress. ### Other symptoms of this complication In addition to movement problems in the fingers, other symptoms may also be seen in the hand: - Inflammation or swelling - sensitivity to touch - pain or burning sensation - itching These symptoms are rare and only about 25% of sufferers experience them. If you experience these symptoms, it is better to consult a doctor; Because it may be a sign of other problems related to the skin or fascia. What is the cause of this complication? The exact cause of Dupuytron contraction is unknown; But genetic and environmental factors play a role in its creation. Some of the most important risk factors include: ### Genetics This disease is seen more in people with a family history. ### age This complication usually occurs in people over 50 years old. ### Gender According to the evidence, men get this disease more than women. ### related diseases Diabetes, epilepsy and some metabolic diseases increase the probability of this disease. ### alcohol and smoking High consumption of alcohol and smoking is associated with increased risk of this disease. ### Specific occupations People who do repetitive activities and put a lot of pressure on their hands may be more at risk. How is it diagnosed? The doctor initially diagnoses this condition with physical examinations and the patient's history. During these examinations, he touches the patient's hand to notice the symptoms. There is no specific test that a doctor can use to diagnose this condition. Only if necessary, he may recommend blood tests or imaging to rule out other possible diseases. What is the treatment? Based on the severity of the symptoms, the doctor suggests appropriate treatment in different stages of the disease. Because the disease progresses slowly, it may take months or even years before you need more advanced treatment. Some patients recover with initial treatments and will not need further measures. If the symptoms of the disease reappear, you may need to repeat the treatments. ### Non-surgical treatments Non-invasive methods to control the disease include the following: - Physiotherapy and stretching exercises help to maintain the range of motion of the fingers. - Using a brace or splint keeps the fingers in a normal position and prevents the progression of the disease. - Treatment with ultrasonic waves or heat increases the flexibility of fascia tissue. - Corticosteroid injection helps to reduce the size of nodules and band tissue. ### Radiotherapy The doctor may refer you to a radiotherapy specialist to prevent the progression of the disease. This method, which is completely painless, uses rays or other waves to soften nodules and banded tissue. Radiotherapy is also used to treat some types of cancer; However, Dupuytron's contracture is not a cancerous disease, and having it does not mean an increased risk of cancer. ### Acupuncture If symptoms do not improve after a few months of initial treatments, your doctor may suggest this method. Acupuncture, also known as percutaneous needle fasciotomy, is an outpatient procedure performed in a doctor's office. In this method, after anesthetizing the hand, the doctor uses a thin needle to make holes in the fascia of the hand so that the stiffened tissues are released and the fingers return to their normal position. ### Collagenase injection In this method, the doctor injects the collagenase enzyme directly into the nodules and band tissue. This enzyme causes loosening and decomposition of abnormal tissues. ### Surgery If the disease progresses so much that it affects your quality of life, you may need surgery. This surgery is usually performed on an outpatient basis and the patient will be discharged on the same day. During this operation called fasciotomy, the doctor removes parts of the damaged fascia. The amount of tissue removed depends on the thickness of the fascia and the degree of bending of the fingers. After the surgery, the patient may need physical therapy or occupational therapy to return the strength and function of the joints to a normal state.