Dupuytren’s contracture
Dupuytren’s is a hand deformity that usually develops slowly, over years. It is a thickening and shrinking of the layer of tissue just under the skin of the palm. It most commonly affects the ring finger and little finger. It can however affect any finger, including the thumb.
What causes it?
The cause of Dupuytren’s contracture is unknown but the risk factors include:
- Age – Dupuytren’s contracture occurs most commonly after the age of 50.
- Sex – Men are more likely to develop Dupuytren’s and tend to have more severe contractures than are women.
- Ancestry – People of Northern European descent are at higher risk of the disease.
- Family history of the disease
- Tobacco and alcohol use
- Diabetes
Symptoms
- The skin of the palm of the hand starts to thicken.
- Lumps or dimples (nodules) in the skin of the palm that consists of hard tissue can develop. This tissue is benign.
- Pain might be associated with the nodules, but usually it is painless.
- The nodules can draw the fingers down into a bent position and prevent you from straightening completely.
- Everyday activities such as placing your hand in your pockets, putting on gloves or shaking hands can be affected.
What can a doctor do to help?
Perform surgery to remove the abnormal tissue, usually through zig-zag cuts in the palm. Surgery may require skin grafts to correct the tightness of the skin of the palm. Surgery is usually recommended to help straighten out bent fingers rather than to prevent the fingers from becoming bent.
What can a therapist do to help?
- Once the finger has contracted it is very difficult to manage conservatively.
- For a mild problem, the therapist can make a custom splint to stretch the fingers out a little straighter and may help regain some movement of the fingers, but it requires using the splint every day. Surgery is recommended in cases where the contracture is moderate to severe and where there is a functional deformity of the finger
- After surgery, a therapy program of massage, wound care, exercises and night-time splinting is important to get the best possible result and prevent recurrence. It is often helpful to wear a splint while sleeping for several months after surgery.
- The therapist can assist you in regaining your function and strength back in you hand following surgery
Schedule an Appointment
For an integrated approach to Occupational Therapy services, contact us on the details below.
Hands, Lymphoedema & Breast Cancer
079 491 6450
hands@otzone.co.za