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Dx Dupuytren Contracture Treatments:

Dupuytren Contracture

The Merck Manual Home Edition
" Dupuytren contracture is a progressive tightening of the bands of fibrous tissue (called fascia) inside the palms, causing a curling in of the fingers that eventually can result in a clawlike hand.

Dupuytren contracture develops in people who are genetically predisposed. Typical symptoms include formation of a nodule in the palm and, eventually, curling in of the fingers.
*Doctors base the diagnosis on an examination of the hand.
*Treatment may involve injection of a corticosteroid into a tender nodule or, if the hand is already scarred, injection of a bacteria-based collagenase into a nodule or surgery to correct contracted (clawed) fingers.
*Dupuytren contracture is a common hereditary disorder that occurs particularly in men, especially after age 45. However, having the abnormal gene does not guarantee that someone will have the disorder.
*About 5% of people in the United States have Dupuytren contracture. The disorder affects both hands in 50% of people. When only one hand is affected, the right hand is affected twice as often as the left.

Dupuytren contracture is more common among people with diabetes, alcoholism, or epilepsy. The disorder is occasionally associated with other disorders, including thickening of fibrous tissue above the knuckles (Garrod pads), shrinking of fascia inside the penis that leads to deviated and painful erections (penile fibromatosis-Peyronie disease), and, rarely, nodules on the soles of the feet (plantar fibromatosis). However, the specific factors that cause the fascia of the palm to thicken and curl in are unknown.

The first symptom is usually a tender nodule in the palm (most often at the third or fourth finger). The nodule may initially cause discomfort but gradually becomes painless. Gradually, the fingers begin to curl. Eventually, the curling worsens, and the hand can become arched (clawlike). The doctor makes the diagnosis by examining the hand.

Medications Used in Treatment:
1. Corticosteroid injections®
2. Surgical release: hand surgery
3. Alternative therapy

Suggested Links:
*N.H.S. Choices

*Dupuytrens Organization

*[Editor] A new treatment with clostridum histolyticum collagenase seems to avoid the need for surgery in many treated.

*[Editor] This information is included for completeness as it has no obvious side-effects and the therapies (vitamins, minerals, Neprinol enzymes, exercise, non-needle Genesen Acutouch pointers, massage, and other disciplines) are benign.

*A colleague reported the topical use of SSKI (Iodine/iodide) and vitamin E for 6 months to reduce/reverse the Dupuytren Contracture. This is from Dr. Jonathan Wright's SSKI and vitamin E treatment protocol reported in the Forum.

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