Deformities - Injuries
Dupuytren disease
Dupuytren contracture is a disease of unknown aetiology, rare in women and common in heavy alcohol users or people with diabetes mellitus.
It is characterized by nodules of the palmar skin and/or progressive contraction of the palmar aponeurosis (a thin membrane beneath the skin in the palm) that leads to varying degrees of permanent contraction of one or more fingers. The disease is progressive but can remain stable for years.
Surgery is the only reliable method of treatment. Under general or block anaesthesia the affected part of the aponeurosis is excised. The use of magnifying loupes and special microsurgical instruments is mandatory because quite often cords of the aponeurosis spiral around fine neurovascular bands and need meticulous separation.
The patient is discharged the same and stitches are usually removed after 2 weeks. Recurrence is rare although contracture of other fingers may develop.
A pharmaceutical factor that causes fibrinolysis can be administered locally in a single shot in selected cases thus releasing the contracture. This factor is not available on the market in Greece currently.
