The disease may be different in the degree of progression. In some cases, it proceeds with skin wrinkling. In others - with rapid contractual formation. Often this ailment bothers the patient for many years.
Initially, a painless small bump appears near the base of the fingers. Often, illness is striking the ring finger, but it may well affect others. Even immediately on both hands. In progression of the disease, bend fingers is becoming more difficult. Sometimes a complete loss of ability to take something in hand is developing. In rare cases, pathology proceeds painfully, especially when drawing the affected fingers.
Often the disease is complemented by the appearance of the inflammatory process on the fingers and the thickening of the fascia. In this case, the disease is called already plantar fasci.
Causes
To date, the exact reason for the appearance of this disease is unknown. There is a view of specialists who say that most often this disease is developing in people suffering diabetes, Alcoholism and Epilepsy. In addition, it is believed that this pathology can be transmitted genetically. But not all people with the right genome inherit this disease.
It is also noted that most often actions manifests itself in men. Sometimes in medical literature indicate that the cause of this disease is physical overload of the brushes. But in fact, not everyone has a contracture of Dupuitren in such a problem.
In addition, many adhere to the opinions that the following risk factors can provoke the development of the disease:
- Chronic trauma.
- Neuropathy of shoulder plexus.
- Hereditary syndromes.
- Inflammatory diseases of the joints.
- Disturbance and drying.
- Infringement of the nerves of the hands.
- Acute or chronic infectious process.
These reasons are not proven by doctors, but in one way or another can contribute to the formation of ailment.
Symptoms
Usually, when inspection, the forced position of the fifth finger is visually determined. In this case, it bends in the first phalangic joint and in relation to the main phalanx is located at right angles. Patients in diagnostics also detects the skin of the skin in the distal palm fold area.
During the painting of the brush, with pathology, the palpal fascination seal is detected. These dense nodules the patient can determine even independently. First, they usually appear in the palm area, and over time they are applied to fingers.
After pricking, the amplitude is usually determined with which the fingers on the hand are inflicted and bend. If there are no guests, the mobility of one or several fingers is reduced, and in severe cases, their movement becomes almost impossible. It is according to the degree of mobility of the patient's fingers determine the stage of the disease. Most often for diagnosis, no additional examinations are required.
When the diagnosis is established, it is necessary to exclude traumatic, neurogenic, rheumatoid and ischemic contractures, which are often developing due to injuries, firearms, open fractures, as well as as a result of muscle damage and tendons. In person with contracture Dupyutrena, such injuries are usually absent.
Treatment
Depending on the stage and complexity of the disease, it is possible both conservative and surgical treatment. In the initial stages, conservative therapy is quite effective. To such methods, in particular, belongs physiotherapy, massage. In the absence of inflammation useful exercises for stretching of the palm fascination. On the night it is recommended to wear lungertie bandages. In some cases, treatment is prescribed with medicines. For example, at local inflammation, injections of corticosteroid drugs are carried out.
If the patient complains of pain, then a local anesthetic is prescribed (for example, novocaine) and glucocorticoid hormone (Kenalog 40, Diprospan, hydrocortisone), which is introduced into the area of the connective tissue. These drugs are able to minimize pain than six to eight weeks.
Often conservative treatment only slows down the development of the disease. For this reason, after a while, surgical intervention will still need. During the operation, the scar cloth is removed. And at the initial stages of the nodule it is possible to remove with the help of aponeryotomy, t. E. needle. Such an operation is best done if the angle between damaged palms and fingers is less than 30 degrees.
The treatment has shown quite effective by means of such a painless procedure as a shock-wave therapy. In this case, the device generates a wave, which is directed to the hearth disease. This impact causes positive changes in the affected fabric. Sometimes a fixed joint is formed so that the fingers cannot bend at all. In some cases, with the increasing connective tissue, which leads to squeezing the nerves and blood vessels, it is recommended to carry out a finger amputation.
Prevention
Due to the fact that the exact cause of the development of this ailment is still unknown, then there are no prevention methods at the moment. To reduce the risk, doctors recommend that the effects of the limbs can be eliminated as soon as possible. In addition, it is recommended to wear protective gloves during various works. It is still necessary to comply with safety. Also, enterprises are encouraged to introduce devices that reliably protect hands from possible damage. Patients who passed through the operation are usually taken under dispensary observation.
