-IBIS-1.5.0-
tx
musculoskeletal system
Dupuytren's contracture
diagnoses

definition and etiology

definition: Contracture of the palmar fascia from increased fibrous formation, causing flexion deformities and decreased function of the fingers.

etiology: The cause is unknown. Men are affected more often than women and there is a > 50% genetic tendency. Usually it begins spontaneously. DC is seen more in invalids; alcoholism; epilepsy; diabetes mellitus; shoulder-arm syndrome after cardiac infarction; liver disease; and pulmonary TB. It usually becomes progressively worse after age 40.

signs and symptoms

• Unilateral or bilateral involvement: When the presentation is unilateral, typically the right hand is more frequently involved.
• Fingers: ring finger is worst, then little, middle and index.
• Palpation: small plaque or nodule develops into a cord-like band.
• Skin puckers around the cord.
• Fingers are fixed in flexion.

lab findings:
• Perhaps (+) deficiency in B6.

course and prognosis

Progression is very variable and may occur over months to years. Conventional treatment advises surgery in advanced cases, although recurrence is possible.

differential diagnosis

• rheumatoid arthritis
• scarring from trauma or burns
• malformation syndromes
• Volkmann's contracture


footnotes