Dupuytren’s Contracture - Dupuytren’s Contracture Herbal Supplements

Basics

Dupuytren’s contracture is a common disease of the hand. The first thing people with Dupuytren’s disease notice is the presence of lumps in the palm. The skin and tissue begin to feel dense and hard. Although Dupuytren’s is progressive, it is not possible to say how quickly the disease may develop. It is also difficult to predict the severity of the disease. One finger or all of the fingers could become involved. Eventually this process pulls the fingers down toward the palm. The tissues become so tight it may become difficult to straighten the fingers. If uncorrected, the fingers develop severe stiffness and deformity results.

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Symptoms

Inability to straighten finger

Painful nodule/ painless thickening in the palm

Decreased range of movement

Thickened facial bands

There may be surgical scars

Check if the flexed finger prevents the palm from being put flat on the table

Common in middle aged males especially Caucasians. There may be a family history. May be a type of fibromatosis

Common in Diabetics, epileptics on chronic Phenytoin therapy, Alcoholics

The following complications might also occur:

Scar You will have a scar on the palm and finger (and in the groin if you have a skin-graft). This will be somewhat firm to touch and tender for 6-8 weeks. Massaging the area firmly with the moisturizing cream can help this.
Nerve damage The nerves running to the fingers can be damaged during the surgery and cause numbness in part of the finger. This complication is unusual in unoperated areas but becomes more common during repeat operations. If this occurs the nerve would be repaired immediately if possible.
Infection Can occur after any operation. This would be treated with antibiotics.
Bleeding Can cause a collection of blood under the stitches which is painful and which can cause problems with the wound. This is usually managed by removing some of the stitches but occasionally it is necessary to return to the operating theatre to stop bleeding. Tell the surgeon if you are on anticoagulants or aspirin.
Stiffness About 5% (1 in 20) of people are sensitive to hand surgery and their hand may become swollen, painful and stiff after any operation (algodystrophy). This problem cannot be predicted but will be watched for afterwards and treated with physiotherapy.
Correction It is often not possible to fully straighten fingers which are very bent at the time of operation, particularly if much of the bend occurs in the middle joint of the finger (PIPJoint). This can sometimes be improved with splinting later after the operation.
Skin loss Portions of the zigzag scars and skin grafts can fail to "take" after the operation. This is unusual if you do not smoke and follow all the advice given.
Finger loss This is extremely rare but can occur in fingers which have had many operations before and in patients who have diseases of blood vessels such as diabetes or scleroderma.
Recurrence Dupuytren’s contracture can return either at site of surgery or elsewhere in the hand. It is very rare under a skin-grafted area.

Prevention

Awareness of risk factors may allow early detection and treatment.

Causes

There has been an association of this condition with systemic diseases, for example, diabetes, epilepsy, Celtic races, and chronic alcoholism. However, this may be more coincidental than an actual cause and effect relationship between these entities. There is no known relationship in most cases and is therefore idiopathic (unknown cause). There has been a case described in the literature of Dupuytren’s contracture arising in a patient following burns to the upper extremity. The authors concluded that burns of the upper extremity should be considered as a trigger to the onset of Dupuytren’s contracture. A recent article found an increased risk of Dupuytren’s contracture in smokers, stating that this may contribute to the association with alcoholism, given the fact that many alcoholics tend to smoke heavily.

Diagnosis

The signs of motor nerve damage are detected by the doctor through the symptoms. Confirmation is done through CT scan.

Dietary Guidelines

A well balanced diet consisting of all essential nutrients and adequate fluid intake help in quick recovery.

Home Care Suggestions

Local protection, stretching exercises, and strong reassurance are all that are required in most patients. But deformities with functional impairment some times make surgery necessary.

Physiotherapy, under supervision, is considered to be quite helpful for most people suffering from Dupuytren's Contractures.

Mind/Body Considerations

Cultivating a positive frame of mind is essential for healing of all conditions and ailments. Mediation and prayer are good ways of relaxing and getting a feeling of well being.