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Re: [IP] Dupuytrens Contracture

email @ redacted asked...
>could someone please explain to all of us what this actually is... i'm hoping
>i'm not the only one who has never heard of it :O(

Well I used to work in a hand therapy clinic, and dupytrens was definately one
of the more prevalent conditions.

AFAIK Dupuytrens, is a condition has its roots in Viking times, it appears
that all cases can be, in some way, traced back to Viking ancestors
(interesting fact huh?).

Simply put, it is a thickening or 'gathering' of the tissues under the skin
(but above the muscles and bones) which acts to pull the fingers (usually only
the pinky and ring fingers, but sometimes the others) into flexion (or bending
them towards the palm), to the point that they are permanently bent that
way....think of it as kind of like web fingers except instead of not being
able to spread your fingers you can't stretch them out straight.

With regards to treatments I believe that the only way to deal with the
problem is what is known as a dupuytrens release, in which a surgeon makes in
incision in the palm of the hand and removes the contracted tissue, thus
releasing the finger(s)....this (from an Occupational therapist's point of
view - that's me) results in a further loss of performance due to the trauma
and scar tissue that the operation leaves behind....but unlike the thickening
fiberous tissue in dupuytrens (which tends to tighten up even more in response
to massage and stretching) scar tissue does respond well to massage and will
initially 'pucker up' but will eventually settle down and allow 'normal'
movements to occur. Therefore the surgery eventually (and usually within 6
weeks or so) results in very good results in terms of being able to do things
as well as cosmetically (the scar may not fade for up to a year, but will

Unfortunately Surgery doesn't 'cure' the problem....but seeing as it is
normally a fairly slowly progressing condition, most people do not find that
they need further surgery (but then some do!!).  One thing we used to
recommend our patients is the use of Vitamin E oil, it can be massaged into
the skin of the palm, it appears to have a slowing effect on dupuytrens (plus
it leaves you with lovely soft hands!!), we also used to tell our clients not
to stretch out their fingers (using force from their other hand) as stretching
the fiberous tissue actually makes the contracture worse.

Hope that answers your questions

Please take all of this as just my clinical experience with Dupuytrens....

Tony Milne (running on insulin)
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