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What Causes Dupuytren's Contracture

October 18, 2020

Dupuytren's contracture is a deformity that affects your hands and fingers. It is also called Dupuytren's diseaseand is primarily a condition that tends to develop over several years. It usually affects one or more of your fingers, with the little fingers being more susceptible to the disease. 

Since there is no permanent cure, nor do scientists know where it stems from, there is no way of measuring how it will affect different people. Some individuals are briefly affected, while the condition becomes severe for others. It may also affect one or both of your hands at the same or different rates.

Dupuytren's contracture is mostly when you get ridges on your palm. These ridges then pull the finger/s towards the palm, essentially contracting the finger itself (hence the term contracture). 

These ridges are formed due to the thickening of a layer of tissue under the skin of your palm and fingers. The thickened tissue then morphs into knots that pull your fingers and bend them. This tissue is called fascia, and it contains strands of fibers that run from your palm towards the fingers like cords. 

These cords are usually flexible, and they help you motorize your fingers and hands like bending them at will or shaking hands with other people. With Dupuytren's disease, you may be unable to perform normal hand functions.  

While the early stages of the Dupuytren's contracture are not treatable, the later stage is. Your finger is usually fully bent, either forming a U shape or a V shape leaning towards the palm in this stage. Once the disease has fully affected your hands, you can then get a fasciectomy to treat it (more on this later). 

Causes

While doctors are not entirely sure about what causes the contracture, they have found certain linkages of the occurrence of Dupuytren's disease with the following: 

1. Having a family history of the condition 

Since many diseases are hereditary, many of which remain unknown, it is likely that they get passed on through the genetic makeup of the lineage. Family histories also make it easier for you to start taking precautionary measures early on, which may help you avoid the contracture. 

2. Excessive smoking

Smoking is dangerous for you, regardless, but it is particularly crucial for people who have a history of contracting Dupuytren's disease. Essentially, smoking dries out your bodily moisture and injects tar into your body, which may have adverse effects on someone who has sensitive skin. Since this disease primarily attacks the skin of your hand, smoking can be particularly dangerous because of the close proximity of the smoke and your hands holding the cigarette. 

3. Excessive alcohol drinking 

Another linked cause of contracting Dupuytren's disease is drinking excessive amounts of alcohol. Once again, since alcohol is also a substance that removes moisture from your body and dries it out, you can become more susceptible to getting it. 

The logic behind this is that when your skin's tissue is not getting enough moisture of its own, it inflates to find that moisture elsewhere, thereby creating knots and becoming almost brittle. It removes the flexibility from your skin, rendering one or more of your fingers bent. 

4. Having diabetes or epilepsy 

Diabetes and epilepsy are mostly hereditary diseases, and while doctors have not yet confirmed them to be direct causes for contracting Dupuytren's disease, they have found patterns of this disease in diabetic and epileptic patients. Thus, to deduce, having epilepsy or diabetes may increase your chances of getting the contracture. 

Additionally, according to Mayoclinic, factors like age, sex, and ancestry are also linked to the disease. For example, the disease mostly only appears after the age of 50. And, men are more likely to contract the disease with a severe effect than women. 

Additionally, people who come from northern European descent are more likely to get the disease. All these factors are speculative and are purely determined on the basis of patterns that doctors have noted. A universal cause is still not confirmed by anyone. 


Complications 

Dupuytren's contracture causes many complications in daily life. While the lumps and ridges that form may be uncomfortable, they are mostly not painful to endure. The skin becomes a little more sensitive, but it is unharmed by any internal or external bacteria. The thumb and the index fingers remain mostly unaffected, and thus, they will still be functional. 

The other fingers may or may not be flexible enough for you to move them. For example, you will not be able to stretch out your hand fully because the other three fingers that comprise most of your hand will be bent (in extreme cases), and you will not be able to open or close your hand entirely. It will be hard to reach for your wallet, shake hands, or grip. These fine motor functions will be affected, but you can get treatment for this. 


Treatment 


There are several different modes of treatment that you can get depending on how severe the condition gets. Your treatment will be based on your overall health, how well you handle your medicine, and whether or not your state is expected to get worse. 

In extreme cases, the surgical method is applied, which is called fasciectomy. In this case, a cut is made along your finger towards your palm for the surgeon to straighten them. You can choose between getting a general anesthetic or a local anesthetic. 

In the former case, you will be put to sleep, and in the latter case, your hand will go numb. You can also leave the hospital the same day since it is not a very complicated operation. You can get one of the following fasciectomies: limited fasciectomy, wide-awake fasciectomy, dermo fasciectomy, and segmental fasciectomy. 

Each of these will simply focus on a certain part of your hand, depending on how severe the condition is. Alternatively, you can also choose radiation therapy, which will be less invasive. The usual recovery time is between 4 to 12 weeks, and postoperative care is very important.        


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