Dupuytren Disease-Dupuytren Disease Overview

Dupuytren Disease Overview
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Dupuytren disease is a fibroproliferative disorder that primarily affects the hands. It is characterized by the development of pathologic tissue in the hands, which originates from existing normal palmar fascial structures. The exact cause of Dupuytren disease is unknown, and diagnosis can be challenging in the early stages. Treatment can be difficult and there is potential for recurrence. The prognosis varies depending on the patient's genetic predisposition.<br /><br />The palmar fascial complex of the hand has five components: the radial, ulnar, and central aponeuroses, the palmodigital fascia, and the digital fascia. The pathology of Dupuytren disease involves the development of nodules and cords, which progressively shorten and lead to joint and soft-tissue contractures. There are several types of cords encountered in Dupuytren disease, including microcords, skin pits, pretendinous cords, vertical cords, spiral cords, natatory cords, central cords, lateral cords, abductor digiti minimi cords, and commissural cords.<br /><br />The clinical presentation of Dupuytren disease varies, but it is more common in men and increases with age. The disease is associated with diabetes and factors such as alcohol consumption, smoking, hypercholesterolemia, and infection with human immunodeficiency virus. Treatment options include observation, steroid injections, enzymatic fasciotomy, radiation therapy, and surgical treatment. Surgical treatment is the most common approach and involves various techniques such as percutaneous fasciotomy, segmental aponeurectomy, partial or limited fasciectomy, dermofasciectomy, extensive fasciectomy, and total fasciectomy.<br /><br />Postoperative care focuses on wound healing and early range of motion exercises. Rehabilitation includes therapy to regain full finger extension and passive and active range of motion exercises. Complications of Dupuytren surgery can include nerve and vascular injuries, tendon injuries, hematoma, infection, wound dehiscence, digital pseudoaneurysm, and recurrence of the disease.<br /><br />Overall, Dupuytren disease is a complex condition that requires careful diagnosis and management. While there are various treatment options available, recurrence is common and the long-term prognosis can be variable.
Keywords
Dupuytren disease
fibroproliferative disorder
hands
pathologic tissue
diagnosis
treatment
recurrence
prognosis
nodules
cords