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Dupuytren's Contracture/Palmar Fibromatosis
Published in Charles Theisler, Adjuvant Medical Care, 2023
Dupuytren’s contracture causes bundles of connective tissue fibers (palmer and digital fascia) on the palm side of the hand to thicken and harden. As the cords tighten over time, they become shorter, typically resulting in one or two fingers (most often the fourth and fifth digits of both hands) being pulled into a permanently bent position at the metacarpal-phalangeal junction, resulting in hand deformity. The disorder is essentially painless but results in abnormal appearance and loss of function.
Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Carpal tunnel syndrome is extremely common, mostly occurring in women between 30 and 50 years of age. Dupuytren contracture is also common, with higher incidence in men over age 45. Adhesive capsulitis affects 10%–46% of people with diabetes annually, and is much less common in nondiabetic individuals. Highest prevalence is between 40 and 70 years of age, with women affected in 70% of cases. There is no specific group of patients affected by sclerodactyly.
The abdomen
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Dupuytren’s contracture This is a flexion deformity, usually of the fourth and fifth fingers (Fig. 4.4). Although there are several other causes for this condition, it may be found in liver disease and alcohol excess.
Upper extremity impairments in type 1 diabetes with long duration; common problems with great impact on daily life
Published in Disability and Rehabilitation, 2019
Kerstin Gutefeldt, Christina A. Hedman, Ingrid S. M. Thyberg, Margareta Bachrach-Lindström, Hans J. Arnqvist, Anna Spångeus
Finger locking, a symptom suggestive of trigger finger, was nearly three-fold more common in patients (31%) than in controls (12%), and the difference was even greater when looking at prior surgery for trigger finger, which was rare in controls with a prevalence of 1%, while 22% of the patients had undergone surgery. Flexed finger (i.e., inability to fully extend the fingers, suggestive of Dupuytren’s contracture and limited joint mobility) was four-fold more common in patients than in controls, i.e., 28% vs. 7%; p < 0.001. The absence of all five upper extremity impairments or previous surgeries was reported by 21% of the patients vs. 56% of the controls (p < 0.001). Eleven % of the patients vs. 2% of the controls who had previously undergone surgery for carpal tunnel syndrome still reported hand paraesthesia in the surgically treated hand. Similarly, 9% of the patients and 0.1% of the controls who were previously surgically treated for trigger finger still experienced problems with finger locking in the same hand.
Peyronie’s disease: new paradigm for the treatment of a unique cause of erectile dysfunction
Published in Postgraduate Medicine, 2020
While there have been many theories of the etiology of PD, most cases are idiopathic and not associated with other disease states. Trauma, either single or multiple small injuries are agreed upon as the primary etiology of PD. Many patients, however, do not recall a specific traumatic event. As a result, most feel that multiple small traumatic events in susceptible individuals is the most likely cause of PD. Trauma to the TA during intercourse may cause micro-hemorrhage, fibrin extravasation, cellular infiltration, and an inflammatory response, inducing deposition of abnormal extracellular matrix. PD patients may have genetic tendency for abnormal wound healing or have connective tissue vasculogenic aberrations or autoimmune disorders[10]. Family history of PD is reported in 2–4% of men and an association with Dupuytren’s contracture (DC) in 20% of patients [8]. Identical twins have been reported to have Peyronie’s disease. In a study of patients with Paget’s disease of bone, a condition characterized by abnormal bone turnover, 14–31% of the patients had PD and 23% had DC [11]. Age is a significant risk factor, with a prevalence of 1.5% in men aged 30–39 years and 6.5% in men older than 70 years [4]. Older men may be more susceptible to penile injury during coitus since erectile rigidity is decreased and the partially erect penis is more likely to buckle during coitus. Trauma to the penis is a common etiology of PD. There is a three-fold increased risk of PD in patients with prior genital or perineal trauma [4]. An association has been reported with urologic procedures including radical prostatectomy, urethral catheterization, and cystoscopy.
Morphological patterns of the pretendinous cord in Dupuytren’s disease: a predictor of clinical outcome?
Published in Journal of Plastic Surgery and Hand Surgery, 2018
P. Vanek, J. Strömberg, J. Fridén, Y. Aurell
This is a prospective study of the ultrasonographic characteristics of the pretendinous cord in patients with a Dupuytren’s contracture in a single finger, and all patients were recruited from a larger randomized controlled study [1]. Between November 2013 and October 2014, 39 consecutive patients scheduled for minimally invasive treatment were included. The affected finger was investigated by the same resident in radiology (P.V.) under the supervision of a senior radiologist specialized in ultrasonography (Y.A.) before randomization and treatment. All 39 patients were treated by the same senior hand surgeon (J.S). The study was approved by the regional ethical committee (EPN 513–12).