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HAND

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Duputryens Contracture

Dupuytren’s Contracture is a hand condition that gradually causes the fingers to bend inward due to thickening of the tissue under the skin of the palm.

  • Definition: A progressive condition where the fascia (connective tissue) in the palm thickens and tightens, pulling fingers usually the ring and little fingers into a bent position.

  • Causes: Exact cause is unknown; linked to genetic factors and abnormal wound healing response in the palmar fascia.

  • Types / Progression:

         ~ Nodules: Small lumps form in the palm
         ~ Cords: Fibrous bands extend to fingers
         ~ Contracture: Fingers bend and can't fully straighten

  • Symptoms: Painless nodules in the palm, thickened cords, difficulty straightening fingers, hand stiffness.

  • Diagnosis Tools: Physical examination; table top test (inability to place palm flat on a surface).

  • Risk Factors: Family history, age (over 50), male gender, Northern European descent, diabetes, alcohol use, smoking.

⁠Rheumatoid Arthritis Deformities

An autoimmune disease causing chronic joint inflammation and damage, resulting in finger and hand deformities.

  • Definition: Autoimmune disease that causes joint inflammation, gradually damaging cartilage and bone, resulting in visible hand and finger deformities.

  • Causes: Autoimmune attack on connective tissues in and around the joint, leading to chronic inflammation and joint erosion.

  • Common Deformities:

         ~ Swan Neck Deformity.
           ~ Boutonnière Deformity.
         ~ Ulnar Deviation.
         ~ Z-Thumb Deformity.
         ~ Joint Subluxation.

  • Symptoms: Joint pain, stiffness (especially in the morning), swelling, reduced range of motion, visible deformity, and hand dysfunction.

  • Diagnosis Tools: Physical exam, X-rays, blood tests (RF, anti-CCP).

  • Risk Factors: Female gender, age (30–60), genetics, smoking, and autoimmune predisposition.

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