Dupuytren contracture steroid injection

Dupuytren's disease (Dupuytren disease), also called Dupuytren's contracture or simply Dupuytrens, is a benign thickening of the palm's or finger's connective tissue. Dupuytren disease is the most crippling hand problem and affecting many people, especially when they get older. Dupuytren disease typically starts with a tiny nodule in the palm. Eventually cords develop and in progressed stages the affected fingers cannot be fully stretched anymore, thus resulting in what is called "Dupuytren's contracture". Note that below picture is showing a very progressed stage of Dupuytren's contracture. Most patients have much less severe symptoms of Dupuytren disease and many people with initial symptoms of Dupuytren's will never need any treatment at all. For those who need treatment, a variety of treatments is available, depending on the stage of disease and on the preference of the patients. All these treatments options of Dupuytren disease are explained on this website, including their potential side effects.

In a study that compared CCH injection versus limited fasciectomy in 132 patients with Dupuytren contracture, Zhou and colleagues reported no significant difference in the degree of residual contracture of the MCP joint (13° with CCH versus 6° with surgery; P = ). With PIP joint treatment, residual contracture was significantly worse with CCH (25° versus 15° with surgery; P = ). However, patients treated with CCH had more rapid recovery of hand function and experienced fewer serious adverse events than did those treated with fasciectomy. [ 76 ]

Two further issues complicate things still further. Firstly diabetic neuropathy is clearly a nerve problem, but not all diabetics suffer from it. As with defining the presence or absence of CTS, we do not have an absolutely reliable way of saying whether any given diabetic patient has neuropathy or not. The nerve conduction studies are much less reliable for diagnosing diabetic neuropathy than they are for CTS. It is quite possible that diabetes might predispose to CTS only through the intermediary of causing diabetic neuropathy and that the median nerve at the wrist might be the first nerve to be affected by some forms of diabetic neuropathy. When studying the association between the diseases we should therefore ideally distinguish between diabetic patients with neuropathy and those without… but we have no reliable way of doing this! One could even argue, in the extreme, that a patient with asymptomatic hyperglycaemia and NCS evidence of median mononeuropathy at the wrist, but no symptoms of anything, actually has the disease – ‘early diabetic neuropathy’.

The surgical procedure for Dupuytren's contracture is known as a fasciectomy, where segments of the palmar fascia are removed. The downside of surgery is that there are significant risks associated with the procedure. The most common is that scar tissue can form after surgery, leading to a problem similar to Dupuytren's contracture, but with scar tissue formation. Also, the Dupuytren's can return, and doing surgery a second time is fraught with problems. Other problems with surgery include nerve injury, infection, and prolonged healing.

Dupuytren contracture steroid injection

dupuytren contracture steroid injection

The surgical procedure for Dupuytren's contracture is known as a fasciectomy, where segments of the palmar fascia are removed. The downside of surgery is that there are significant risks associated with the procedure. The most common is that scar tissue can form after surgery, leading to a problem similar to Dupuytren's contracture, but with scar tissue formation. Also, the Dupuytren's can return, and doing surgery a second time is fraught with problems. Other problems with surgery include nerve injury, infection, and prolonged healing.

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