A person's hands have long been used to assess the standard of living and prosperity. It is believed that the lines on the hands can tell about the fate of a person. Also, by the appearance of the hands can judge the state of health. In addition, there are pathologies that appear only on the hands. Such pathologies include Dupuytren's contracture, which is also called palmar fibrosis. Dupuytren's contracture is a disease of a non-inflammatory nature, which is characterized by cicatricial degeneration of the tendons in the palm of your hand. Clinical manifestations and methods of treating pathology, read further in our article.
How does Dupuytren's contracture develop? Specific symptoms
The reason for the formation of Dupuytren's contracture has not yet been clarified. There are 3 development theories – constitutional, traumatic and neurogenic. The disease develops gradually. More often, the pathology occurs in middle-aged men and in half of the cases it is bilateral.
Against the background of the growth of the connective tissue, the tendons of the hands are shortened, this provokes limitation in the extension of one or more fingers. This is how flexion contracture develops with partial loss of hand function.
The clinical manifestations of Dupuytren's contracture are difficult to confuse with other pathologies due to specific manifestations.
Main characteristics and symptoms of Dupuytren's contracture:
- Pathology begins with the formation of a seal on the palm, which is formed by a knot and several strands.
- Finger extension is limited.
- Usually, a seal is formed in the area of the metacarpal – phalangeal joint of 4-5 fingers.
- Further on, the nodule slowly and gradually increases in size. The tendon is shortened, which is accompanied by contracture in the metacarpal – phalangeal joint, and then in the proximal interphalangeal joint.
- The skin over the knot becomes very dense and adheres to the underlying tissues. This contributes to the appearance of retraction and bulge in the affected area.
- The knot and bands become more visible when trying to straighten the finger. Only in a tenth of patients Dupuytren's contracture is accompanied by minor pain. The disease has a progressive course.
Conservative treatment of Dupuytren's contracture
The method of elimination of Dupuytren's contracture is selected individually depending on the severity of pathological changes. At the beginning of the development of contracture, conservative therapy is used. What is the conservative treatment of pathology, knows estet-portal.com. Special exercises for stretching the palmar aponeurosis and thermal procedures are prescribed.
It is effective to use removable splints that fix the fingers in an extended position. They are put on at night and taken off during the day.
In the presence of pain, blockades with hormonal drugs are performed. The effectiveness of one blockade lasts up to 2 months. The use of hormonal drugs should be carried out with caution after examining the patient and studying his endocrinological profile.
Surgical treatment of Dupuytren's contracture
The only radical treatment is surgery. The decision on surgical treatment is based on the rate of progression of the disease and on the patient's complaints of pain and a progressive decline in quality of life. Surgery is recommended if there is a flexion contracture with an angle of 30 degrees or more.
During the operation, the scar tissue is excised, after which the full range of motion in the joint is restored. In severe cases, it is proposed to create a fixed joint with fixation of the finger in a functionally comfortable position. Surgery is performed under general anesthesia, as the procedure is lengthy. After surgical treatment of Dupuytren's contracture, therapeutic exercises are recommended to restore the range of motion in the fingers.
Share:
Add a comment