Dupuytren’s Contracture and Physiotherapy Singapore
Named after Baron Dupuytren, Dupuytren’s contracture (also knowned as Dupuytren’s disease and palmar fibromatosis), is a flexion contracture of the finger(s), and cannot be extended (straightened).
This disease is caused by contractures and tightening of the fascia of the palm, and most of the time, it affects the ring finger and little finger more commonly. Sometimes it may affect the middle finger, but the index finger and thumb are always spared. Dupuytren’s contracture is a very silent, progressive and painless disease, occurring in such a way that patients often overlook it as just stiffness from old age that they need not deal with, until it is very late.
What happens is that the palmar tissues thicken and shorten such that tendons moving the fingers become stuck, and cannot move or glide smoothly, causing stiffness and eventually flexion contractures. Dupuytren’s disease incidences increases after 40 years old, affecting more men than women.
As the connective tissues within the palm thickens, it can cause fingers to curl and stay curled, decreasing mobility, function and use, especially in the ring and little fingers. Sometimes, it may be misdiagnosed as a neurological problem further up the nerve distribution, but with differential diagnoses, hand therapists can tell accurately the main cause of the problem, which is the hardened connective tissue in the palm. Sometimes, it presents as a lump or a bump in the palm, which can be tender, and progressively hardens and/or enlarges.
These begin as palpable first, and as they enlarge, they become more obvious to the eye, and may appear as a small callus.
Hand therapy and/or physiotherapy intervention is crucial at early symptoms, as aggressive hand therapy will result in improved mobility and function. Treatments will include Deep Tissue Massage, Electrotherapy, scar management, strengthening and stretching as well as joint range of motion management. If necessary, we will refer you to our orthopedic surgeons for a release operation.