Sunday, November 9, 2008

Dupuytren's contracture

1. What is the mechanism of Dupuytren's contractures?
2. What factors predispose to Dupuytren's contractures?
3. What is seen clinically?
4. What is the treatment?

Answers:
1. Thickening of the palmar fascia due to fibrous proliferation.
2. Genetics (Northern Europeans), DM, EtOH, epilepsy, pulmonary TB, men > 40.
3. Painless nodules in distal palmar crease, initially nontender but may become tender. Involved finger may be drawn into flexion.
4. US, splinting, massage, possible surgical release if severe.

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