Dupuytren's disease, also known as Dupuytren's disease, fibromatosis of the palmar fascia or Dupuytren's contracture, is characterized by restricted movement of the fingers.
Here you will find all the important information and qualified Dupuytren's disease specialists.
Dupuytren's disease is primarily characterized by restricted movement of the fingers. Those affected can no longer stretch their fingers, causing them to bend towards the palm. The disease is named after the French surgeon Baron Guillaume Dupuytren, who first described the phenomenon of bent fingers in 1832.
In Dupuytren's disease, the connective tissue in the palm area is restructured and more collagen is formed. This results in thickened cords and lumps in the area of the palms and fingers. These severely restrict the mobility of the fingers, ultimately leading to the development of Dupuytren's flexion contracture.
What exactly causes these changes in the hands is not yet fully understood. As Dupuytren's disease runs in families , researchers assume that genetic factors play a role in the development of the disease. Presumably, changes in certain gene areas disrupt cell function and thus lead to the connective tissue remodeling processes. In people with the corresponding predisposition, the remodeling processes are apparently initiated by injuries or other triggers.
Furthermore, a connection between Dupuytren's disease and other diseasescan be observed. These include
The disease generally develops rather slowly. At the beginning, patients often only notice soft nodular changes or dents in the area of the palms. Only at a later stage do the typical rough lumps and firm cords appear on the fingers and/or palms.
The immobility of the fingers increases as the disease progresses, but there is no pain. People with Dupuytren's disease are initially unable to stretch one finger, and later several fingers. Gradually, the fingers bend more and more inwards towards the palm. The ring finger and little finger are most frequently affected by the contracture. In the majority of patients, Dupuytren's disease occurs in both hands.
Dupuytren's disease on the ring finger of the right hand; by Frank C. Müller, CC BY-SA 4.0, Link
f fibromatosis of the palmar fascia is suspected, the doctor first examines the hands. If the fingers cannot be stretched and/or are inclined towards the palm, this indicates Dupuytren's disease. Nodules and cord-like connective tissue changes can also be felt in the palm of the hand. Thickening of the fingers (knuckle pads) is also usually noticeable.
However, limited finger mobility can also be due to other causes. To rule out other possible underlying diseases, such as osteoarthritis of the finger joints, the doctor may order an X-ray examination.
The treatment of Dupuytren's disease consists of surgery on the hands, especially in more advanced stages of the disease. Various surgical procedures can be useful to restore the mobility of the fingers. For example, the thickened connective tissue cord can be cut or excised. Depending on the severity of the disease, the connective tissue plate of the hand can even be completely or partially removed. The following applies: the more generously the surgeon removes the affected tissue, the lower the risk of relapse.
Healing is very slow in many patients. There is a risk of scar contracture, where shrinking scar tissue restricts the mobility of the fingers again. Physiotherapeutic treatment measures can usefully support rehabilitation after the operation so that patients can regain the desired mobility in their hand and fingers more quickly.
Non-surgical measures are also available for the treatment of Dupuytren's disease. For example, X-rays as part of radiotherapy can slow down the progression of the disease. The hardened connective tissue cords of the fingers can also be treated using a so-called needle fasciotomy. These non-surgical treatment options are particularly suitable for the early stages of the disease. However, as many patients only consult a doctor once the contracture has progressed, hand surgery is often the only option for treating Dupuytren's disease. Surgery is strongly recommended, especially if the fingers are flexed by more than 30 degrees.
Dupuytren's disease is therefore a disease that is associated with significant movement restrictions for patients, especially in the advanced stages of the disease. Early treatment can improve the mobility of the fingers and possibly prevent surgery.
Dupuytren's disease specialists are qualified specialists in hand and plastic surgery. Before specializing, the specialists have completed several years of basic surgical training at the relevant clinics. This is followed by specialist training as a plastic surgeon at clinics for plastic and hand surgery. Specialists in Dupuytren's disease can look back on comprehensive surgical specialist training as well as highly specialized further training in the latest research at specialist clinics in Germany and abroad.
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