Dupuytren’s contracture is a progressive hand deformity characterized by the thickening and tightening of the fascia, a layer of connective tissue beneath the skin of the palm. As the condition progresses, it can form rope-like cords that pull the fingers into a bent position(curling inward), making it difficult to straighten them.
It is also known as Viking disease, Morbus Dupuytren, palmar fibromatosis. Dupuytren contracture most often affects the two fingers farthest from the thumb. This can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands.
There are two primary types of Dupuytren’s contracture:
• Primary Dupuytren’s Contracture: This form tends to develop gradually and has no clear cause.
• Secondary Dupuytren’s Contracture: This type can occur as a result of other factors such as hand trauma or certain medical conditions.
• Early symptoms include the development of small, tender lumps in the palm.
• Over time, thickened cords may form, causing one or more fingers to bend inward.
• The affected fingers might have difficulty straightening, impacting daily activities.
The exact cause of Dupuytren’s contracture remains unclear, but several factors may contribute:
• Genetics: A family history of the condition increases the risk.
• Age and Gender: Dupuytren’s is more common in older men.
• Ancestry: People of Northern European descent are more susceptible.
• Smoking and Alcohol: These lifestyle factors may elevate the risk.
Risk Factors –
Several factors increase the likelihood of developing Dupuytren’s contracture, including advancing age, male gender, family history, and certain health conditions like diabetes and epilepsy.
While Dupuytren’s contracture itself isn’t life-threatening, complications may arise, including:
• Impaired Hand Function: As the fingers contract, everyday tasks become challenging.
• Contracture Recurrence: After treatment, the condition may reoccur.
• Difficulty in Grip: Grip strength may be compromised, impacting work and daily activities.
• Diagnosing Dupuytren’s often involves a physical examination and medical history review.
• Doctors may assess the extent of finger contracture and palpate for nodules or cords.
• In some cases, imaging tests like ultrasound or MRI can provide a detailed view of affected tissues.
Several treatment options aim to manage Dupuytren’s contracture:
• Watchful Waiting: In mild cases, monitoring progression without immediate intervention may be appropriate.
• Medications: Collagenase injections can help break down the thickened cords.
• Needle Aponeurotomy: A minimally invasive procedure using a needle to puncture and release the cords.
• Surgery: Fasciectomy involves removing the affected tissue, and in severe cases, joint contracture release may be necessary.
Ayurvedic Treatment –
Ayurveda suggests two type of treatment for such type of contracture management –
▪︎ local treatment
• Swedana – local fomentation
• Pain-relieving lepa application
• Kanchnar Guggulu
• Vrihat Vatachintamani Ras
Prevention and Lifestyle –
While there’s no guaranteed prevention, certain lifestyle measures may help reduce the risk or slow progression. Maintaining a healthy lifestyle, avoiding smoking, and moderating alcohol intake are recommended.
Dupuytren’s contracture is a complex hand condition with various contributing factors. Early detection and appropriate management are crucial for maintaining hand function and quality of life. Individuals experiencing symptoms or at higher risk due to family history should seek timely medical evaluation for personalized care.
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