Dupuytren's Contracture
Description
Dupuytren’s disease (DD) is a fibroproliferative disorder of the palmar and digital fascia, whereby a thick collagen cord develops, causing flexion deformity of the affected metacarpophalangeal (MP) or proximal interphalangeal (PIP) joints. Dupuytren’s has a strong genetic link, and patients with Type II diabetes mellitus are more likely to develop the disease.
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Signs & Symptoms
- The lesion activity and the ensuing deformity rate vary considerably.
- Occasionally, a finger may become markedly flexed within a few weeks or months. Severe deformity usually requires several years.
- Lesions can progress steadily or exacerbations and remissions can occur. Regression is rare.
- Most commonly begins on the ulnar side of the hand at the distal palmar crease and progresses to involve the ring and little fingers.
- Metacarpophalangeal and proximal interphalangeal joint flexion contractures gradually develop.
- Discomfort is rare and usually consists of itching or occasional pain early in the development of the nodules.
Diagnostic Tests
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Fasciectomy/aponeurectomy
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PT Implications
- Referral to a hand specialist and orthopedic surgeon may be indicated.
Goals:
- Stretching and ROM exercises to delay onset of contractures may help
- Assist with modifications for ADL performance
- Work with a hand specialist/orthopedic surgeon to manage post-operative rehabilitation protocol if surgery is indicated