2023-09-09 20:45:00
Hook hands
Approximately 9 to 20% of adults experience this pathology. In a disease called “Dupuytren’s contracture,” a progressive lesion of the aponeurosis (a wide tendon plate) covering the ligaments, nerves and vessels of the hand develops. The resulting thickening and shortening of the palmar fascia leads to flexion deformation of the fingers with disruption of their functions.
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The reasons for the development of this fibromatosis are unknown. It is believed that metabolic disorders, endocrine diseases (especially diabetes mellitus), chronic intoxication, and autoimmune disorders contribute to the occurrence of the disease. Most scientists are confident in the hereditary nature of the disease. Often, certain types of work that are associated with tension in the hand muscles, local vibrations and injuries lead to the disease. Dupuytren’s contracture develops in adulthood or old age and usually affects men. People with nicotine and alcohol addiction are more susceptible to it. Young people rarely suffer from this disease, but when it starts early, it is more severe. The rapid progression of the pathology very often leads to serious functional disorders that interfere with professional activity and even lead to disability.
The onset of the disease is accompanied by the appearance of nodules, compactions or cords on the palm, not accompanied by painful sensations. The skin becomes thickened, additional folds are visible on it, and the palm wrinkles. The pathological process often occurs asymmetrically – different arms are affected at different times. Usually the ring finger is the first to be affected, so the symbol of the International Society for the Fight against Dupuytren’s Contracture has become the image of a palm with a tucked ring finger. The little finger and middle finger also suffer quite often, especially with severe disease.
You can make a preliminary diagnosis yourself – you just need to put your palms on the table and find out how tightly all your fingers adhere to its surface. If a pencil or ballpoint pen can be inserted between the table and any finger, you should immediately consult a doctor (surgeon or traumatologist). Already at the initial stage, it is more difficult for the patient to wash his hands, greet other people, and put his hands in his pockets.
To make a diagnosis, in addition to examination, it is necessary to conduct an ultrasound or x-ray examination of the hand, but with severe symptoms this is not necessary. Treatment can be conservative or surgical. In the early stages, before the appearance of pronounced contractures, the use of glucocorticoids or collagenase injected into the affected area is quite effective. But more often surgery is used to help with significant lesions. Unfortunately, any treatment method does not protect against possible relapses of the disease, which occur quite often. There is no specific prevention, but you can reduce the risk of developing Dupuytren’s contracture by getting rid of bad habits and other risk factors, including occupational ones.
Yury KUZMENKOV, doctor, RNPC “Cardiology”.
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