Dupuytren’s contracture, also known as Viking disease, is a medical condition where the fingers start to bend in a flexion position eternally. This condition is a deformity disorder of the connective tissue. The condition results in the thickening and shortening of the connective tissues of the hand, together with the fascia.
Dupuytren’s contracture symptoms
The development of Dupuytren’s contracture is slow and can affect both hands, where the ring finger and little finger are mostly affects.
Early signs of Dupuytren’s contracture:
Thickening of the tissues under the palm
Formation of small, hard nodules under the palm
The skin on the palm puckered or dimpled
Nodule feels soft but not painful.
The later stage of Dupuytren’s contracture
Cords of tissues develop under the skin, shortened and tightened, damaging the finger operations.
As the cords tighten, they pull the fingers toward the palm, making it difficult to straighten out the fingers.
Difficult to put the palm flat on the surface or open the hand completely.
The sensation of aching, pain, and itching develops with the contractions.
Decrease a person’s ability to grab large objects and make simple movements like washing their face or wearing gloves.
Dupuytren’s contracture causes
Though Dupuytren’s Contracture or Viking hand is reported as early as in the 1600s, at this stage, the real causes of Dupuytren’s contracture are still to be known.
There is no solid sign that hand injury or professions that include vibration to the hands causes the condition.
However, some risk factors increase the risk of the disease.
Age: Statistically, Dupuytren’s Contracture happens most commonly after the age of 50.
Gender: Male is to expects more to develop this disease and have the more serious conditions than women
Ancestry: A person of an inherited Northern European descent is at higher risk of contracting this disease. For ethnic groups like Chinese and Africans, Dupuytrens are rare.
Family history: It is proven that usually, Dupuytren’s contracture runs in the families
Tobacco and alcohol use: Alcoholism and smoking are also linked with Dupuytren’s contracture
Chronic illness: Diabetes people are also report to have a higher risk of the condition.
Diagnosis of Dupuytren’s contracture
Look and feel: Compare the hands to each other to check for grooves and pits on the skin of the palms.
Table-top test: Putting the hand flat on a flat surface like a table to see if it lies flat.
Grip Test: To test how well you can hold an object with your hands.
X-rays recommended orders to check if Dupuytren’s contracture and Vikings Diseases because of other contributing bony abnormalities.
Who gets Dupuytren’s disease?
Dupuytren’s disease is somehow known as the curse of the Vikings and is essentially in those descend from Celtic races like the Scots and Scandinavians. However, it is less common in Indians, South Americans, and people from the Middle East.
Dupuytren’s disease happens more commonly in men and tends to happen younger in men than in women, usually starting in the 50s in men.
Smoking is a risk factor and is another reason to quit in those suffering from Dupuytren’s disease.
There are several other link disease states, but most people have none of these and happen to have DD.
Why do the fingers bend towards the palm?
The irregular cells in the DD tissue have components of muscle fibers within them, and these muscle fibers contract because the contracting tissues lie under the palm side of the fingers; contraction causes flexion.
The flexion deformity progress till the fingers contract towards the palm.
Is there anything to avoid developing the disease?
There are no known measures to avoid disease development, although patients who smoke must quit.
There are three main types of surgical procedures:
Open Fasciotomy: Fasciotomy acutely means ‘cutting thick tissue.’ The skin around and above the nodules and cords is cut to open the hardening tissue. The hard tissue is then cut, and the skin is stitch back. This is a minor process are done on a patient basis under local anesthesia.
Needle Fasciotomy: The process is also known as needle closing fasciotomy or aponeurotomy. The disease is namely stopping because the doctor doesn’t cut the overlying skin to cut the solid tissue. Instead, a hypodermic needle gets inserts into the skin overhead the contracture, and the tissue to cut it. This is a minor process and especially it is performing for outpatient with the help of local anesthesia.
While this is an easy and quick process without extensive surgery, it has got its drawbacks like:
Performing the procedure if the nodule or cord is not adjacent to any important nerves.
The procedure for the disease is not recommending for severe contractures of more than 40 degrees.
Reports advise that there are high probabilities of contracture reappearance following this process. Usually, the reappearance happens after 3-5 years of the process.
Since the skin is not opening, there is a high chance of damaging the nerves, blood vessels, or muscles, leading to long-term complications.
