Dupuytren’s Contracture

Dupuytren’s contracture is a condition where the palmar fascia, a thin muscle type sheet of tissue under the palm, thickens and contracts.

Dupuytrens contracture usually affects the ring and little fingers, but sometimes cords can form in other fingers. You can have it in both hands at the same time, or just in one hand. Usually the age of onset is over 50 but you can develop the condition prior to that.

It can stay the same over many years, and not cause any problems, or can worsen.

Dupuytrens contracture

Cauze

The exact cause of dupuytrens is not known. It has been linked to:

  • Having a relative with the same condition
  • Being male
  • Increasing age
  • Fumat
  • Drinking a higher than average amount of alcohol
  • Having diabetes or epilepsy

Sometimes working heavily with your hands can aggravate the condition.

Simptome

  • You may notice some thickening of the tissue in the palm or bumps (“nodules”) forming.
  • In some cases, the tissue forms cords under the skin that can pull the fingers towards the palm.
  • If your contracture gets worse, it may bend your fingers towards the palm, causing difficulty with everyday living tasks such as washing your face, putting your hands in your pockets or grasping for objects.

Tratament

You cannot prevent progression of the disease. There is no evidence that stretching the affected finger or wearing a splint will help. Sometimes the nodules in the palm may be painful but this usually settles over time. You may wish to avoid heavier tasks that aggravate the site of the nodules to see if that helps relieve the pain.

You should continue to use your hand as normally as possible. Speak to your healthcare practitioner if your finger starts to cause problems with your everyday function, or if the smaller joints in your fingers are affected.

Ameliorarea durerii

Medication (such as simple painkillers or anti-inflammatories) may be useful. A pharmacist or your healthcare practitioner can help advise you what to take if needed. You can find further information here on what medications you could take here:

Cum și când să luați paracetamol pentru adulți - NHS (www.nhs.uk)

Ibuprofen pentru adulți: analgezic care tratează și inflamațiile - NHS (www.nhs.uk)

Terapie cu gheață sau căldură

Căldura vă poate fi de ajutor pentru a ușura rigiditatea și durerea articulațiilor. Încercați să umpleți un bol cu apă caldă sau să vă sprijiniți mâna pe un pachet de căldură încălzit la microunde timp de 10 minute. Nu utilizați căldura dacă articulația dvs. este fierbinte și umflată, deoarece ar putea să o înrăutățească. În schimb, puteți lua în considerare utilizarea unui pachet de gheață sau a unei pungi de mazăre congelată.

Puneți un prosop de ceai pe încheietura mâinii (pentru a vă proteja pielea de arsurile provocate de gheață), apoi puneți un pachet de gheață sau o pungă de mazăre congelată peste zona dureroasă. Lăsați acest lucru timp de zece minute și utilizați de până la 3 ori pe zi.

  • Vă rugăm să fiți prudent în utilizarea gheții dacă aveți senzații modificate sau probleme circulatorii.
  • Verificați pielea în mod regulat și opriți-vă dacă există durere excesivă sau furnicături.

Hand Exercises

General movement of the hand can be beneficial to improve/maintain range of movement and prevent stiffness.

Chirurgie

You may be referred to a hand surgeon for assessment if your symptoms are affecting your function, or if a contracture occurs in your fingers. Surgery does not stop the progression of the disease but can help improve your day to day hand function.

Surgical options include a needle fasciotomy (where a sharp needle is used to cut through and break the cord, releasing the finger), a fasciectomy (where the tight tissue is removed surgically, via an operation) and a dermofasciectomy (where a small skin graft is put in). You may need further surgery in time if the contracture comes back. You can find out more about this here:

Dupuytren’s disease | The British Society for Surgery of the Hand (bssh.ac.uk)

NHS Decision Support Tool

Decision support tools are designed to support shared decision making between people and a clinician. People may find they are useful before, during or between consultations depending on their care pathway.

This document is called a decision aid. It is designed to help you decide between treatment options. You should go through it and talk to your healthcare professional.

This decision aid is for you if you have been told by a healthcare professional that you have Dupuytren’s contracture and are having symptoms

NHS_Dupuytren’s_contracture_decision_tool (england.nhs.uk)

Înapoi la condițiile mâinii și încheieturii mâinii