Dupuytren’s Disease Flashcards
1
Q
What is the general population of Dupuytren’s Disease
A
Mainly affects adult males 40-60
*unknown etiology
*risk factor is hand surgery
2
Q
What is the patho physiology of Dupuytren’s Disease
A
- Proliferative fibrodysplasia
*palmar fascia becomes thickened and contracts
*tissue shortens, may forms nodules or puckering of the skin - Contracture develop as the fascia shortening progresses
- Can envelop surrounding structures and become closely adhered to the skin
3
Q
What are the risk factors of Dupuytren’s Disease
A
- Family history
- Common in Australia
- Diabetes, alcohol consumption, smoking
4
Q
What is the presentation of Dupuytren’s Disease
A
- Stiffness and inability to straighten affected fingers
*4th and 5th - Nodules/swellings in the palm
5
Q
What will be found with the PE?
A
- Palmar fascia
*palpable thickened cords - Tender to palpation
- Nodules
- Contractures (4th and 5th fingers)
*MCP MC
6
Q
What is the pathognomonic sign of Dupuytren’s Disease
A
Nodule at distal palmar crease or at proximal phalanx of fingers
7
Q
What are some associated findings of Dupuytren’s Disease
A
- Peyroine’s disease
- Lederhosen’s disease
- Dorsum of PIP joints
8
Q
What are the complications?
A
- Surgery can cause
*nerve damage
*incomplete correction (need to maintain flexion for gripping)
*skin necrosis
9
Q
What is the treatment of Dupuytren’s Disease
A
- Watch and wait
- Extension bracing initially/early
- Cortisone injections to painful nodules
10
Q
When is surgery indicated>
A
- Until the contracture is 30 degrees or more present at the MCP or PIP joints
*surgery includes removing segments of the palmar fascia/excise nodules
*Z-plasty incision MC
*followed by splinting and therapy
11
Q
What is needle aponevrotomy? Dupuytren’s Disease
A
Use a chemical that breaks down the palmar fascia
*let the chemical sit then stretch out the finger
