Dupuytren’s Contracture Flashcards
What is Dupuytren’s contracture?
It is defined as a condition in which there is development of cords within the palmar fascia, leading to contracture and flexion deformity
Which two fingers are most commonly affected by Dupuytren’s contracture?
Ring finger
Little finger
What nine risk factors are associated with Dupuytren’s contracture?
Older Age > 65 Years Old
Male Gender
Northern European Descent
Family History
Diabetes Mellitus
Alcoholic Liver Disease
Phenytoin Administration
Smoking
Mannual Labour
What are the three clinical features of Dupuytren’s contracture?
Thickened Palmar Skin
Palmar Crease Nodule
Fixed Flexion of MCP & PIP Joints
What investigation is used to diagnose Dupuytren’s contracture?
Hueston’s Test
How is Hueston’s Test conducted?
It involves asking the patient to place their palms down onto a flat surface
What Hueston’s test result indicates Dupuytren’s contracture?
When individuals are unable to place their palms onto a flat surface and there is greater than 30 degrees of flexion at the MCP joint
When is hand clinic referral recommended in Dupuytren’s contracture?
It is recommended to manage Dupuytren’s contracture in which the MCP joint cannot be straightened, and individuals present with a positive Hueston’s test
When is conservative management of Dupuytren’s contracture recommended?
It is used to manage Dupuytren’s contracture which has minimal functional impairment
What is conservative management of Dupuytren’s contracture?
It involves reassurance and safety netting
What is the pharmacologcial management option of Dupuytren’s contracture?
Collagenase Injections
How are collagenase injections used to diagnose Dupuytren’s contracture?
It is an enzyme that results in lysis of collagen deposits within the palmar fascia
What are the two surgical management options of Dupuytren’s contracture?
Percutaneous Needle Fasciotomy
Fasciectomy
What is percutaneous needle fasciotomy?
It involves insertion of a fine needle to break up the palmar crease fascia cords/nodules
When is fasciectomy used to manage Dupuytren’s contracture?
It is used to manage recurrent disease
