-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