Dupuytren's Contracture

Dupuytren's Contracture

Dupuytren's Contracture is a flexion contracture of one or more fingers (most often the third and/or fourth) of the hand, resulting from compression of the superficial palmar aponeurosis and fusion of the flexor tendon of the affected finger with the skin of the palm.

This contracture is eliminated surgically - by separating the fibrous fibers with which the tendon is attached to the skin.

ISCHEMIC VOLKMANN'S CONTRACTURE (Volkmann's contracture) is a contracture of the hand (less often the foot) with a claw-like position of the fingers, resulting from fibrosis and shortening of muscles caused by a violation of their blood supply.

Typically, such contracture is a complication after fractures, in the treatment of which tight bandages and plaster corsets were used.

Dupuytern and Volkmann contractures: the most common types

Contracture and Dupuytard's contracture, more commonly known as Duputurne's contracture, is a pathological condition in which the tendons and muscles of the hand are compressed, resulting in deformation of the hand. Volkmann's contracture is a rare disease affecting the soft tissues, namely the external epicthetic meat.

Dupithurne's contracture can be caused by a variety of conditions, such as arthritis, tendon damage, sprains, minor injuries, or heredity. Most often, the disease manifests itself when a person reaches middle or old age - it begins with the formation of nodules on the palmar surface of the hand, from where it moves to the adjacent phalanges of the fingers. The nodules give the hand a claw-like appearance and can lead to poor circulation, weakness and loss of sensitivity in the fingers.

Most cases of Volkmann's contracture are associated with surgery, but not all cases are associated with surgery. In practice, the most common cause of this contraction is injury, for example, muscle strain during decomposition. However, sometimes Volkmein contracture is a consequence of chronic injury. Here we are talking about constant exposure over time. For example, if the injury was sustained in a car accident during an accident.

How to treat it?

At the initial stage of the disease, it is necessary to treat conservatively, without surgical intervention. To do this, they do massage, exercises, and it is recommended to wear a special glove. In more advanced cases, surgery is resorted to. Traumatologist conducts

Contracture is a decrease in the range of motion in a joint. With Volkmann's ischemic contracture, the lesion is associated with impaired blood flow through the arteries supplying the hand. In this case, two fingers of the hand are affected. As a rule, this is the little finger and the ring finger. In addition, the middle finger may also be affected. Flexion contractures of the fingers with a predominance of supination gradually develop. This may manifest itself, for example, in the fact that when shaking hands, the patient cannot keep the palm folded, easily releasing the fingers outward.

Over time, patients develop a clinical picture of muscular atrophic diseases characteristic of progressive muscular dystrophies. These are manifestations of trigger points, impaired muscle trophism and the gradual death of damaged muscle fibers. In the area of ​​the affected fingers, trophic changes in the skin, bone deformities, and damage to tendons and ligaments may be observed. Therefore, the patient may develop trophic ulcers, separation of nails like a “bird’s beak”, changes in skin color between the fingers and around them.