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Cosmetic SiteDupuytren's Contracture
What is Dupuytren's contracture?
Dupuytrens disease may present as a small lump, pit, or thickened cord in the palm of the hand
Dupuytren's contracture is athickening of a heavy fibrous sheet of tissue that lays between the skin of the palm and the deeper structures of the palm(tendons, muscles, nerves). We are not sure why this tissue tends tothickenand contract. Oftentimes this is an inherited illness occurring more frequently in people of Northern European heritage. It is not believed that it is due to any type of injury or trauma. There are no exercises or splints that can significantly alter the course of the disease.
In advanced cases, a cord may extend into the finger and bend it into the palm
How is it treated?
Surgical intervention is usually recommended when the tight band begins to interfere with function of the joint. The treatment includes release or complete excision of the offending band. Oftentimes alterations of the skin are required due to the shortening of the skin along with the shortening of the band. This may involve the use of grafts or flaps of skin to alter the skin that is left behind, or in some cases, the wound is simply left open to heal on its own.
Table Top Test
Treatment Diagram
There is a significant recurrence rate with Dupuytren's contracture and someof this depends on the severity of the disease process in each individual patient, as well as the operation used to remove the disease. The surgery is usually an outpatient operation. The patient may have a general anesthetic, or more commonly with less severe cases, a block anesthesia in which the arm is made numb temporarily. Postoperatively usually a bulky cotton dressing is placed and in some patients a splint is required. The key element in the recovery in most patients is following the postoperative therapy and splinting instructions to prevent stiffness of the joints and recurrence of the tight band. In short, removal of the Dupuytren's disease is perhaps half to three-quarters of the job. The remainder of the determinant of the final success is following postoperative exercises and splinting instructions.