Dupuytrens Contracture occurs in
High-Yield Explanation
(Palmer fascia): (293- Maheshwari 4th edition)Dupuytren's contracture (Contracture of the palmer aponeurosis)DUPUYTREN'S CONTRACTURE:- This is nodular hypertrophy and contracture of the superficial palmer fascia (palmar aponeurosis) Autosomal dominant trait* More common in males than female, prevalence increases with age. * High incidence in epileptics receiving phenytoin therapy associations with diabetes, smoking alcoholic cirrhosis AIDS, and pulmonary tuberculosis* Middle aged men-complains of a nodular thickening in the palm, Gradually this extends distally to involve the ring or little fingers, sometimes the dorsal knucle pads one thickened (Garrod's pad), nodules on the soes of the feet (Ledderhose's disease)* There is rare, curarior association with Fibrosis of the corpus covemosum (Peyronie's disease)Treatment* Surgery does not cure the disease, it only partially corrects the deformity and recurrence or extension is common* Treatment of choice - subtotal fasciotomy*** Complete fasciectomy is usually unnecessary and fraught with complications* Amputation is occasionally advisable for severe, recurrent disease in the little fingers. Profound stiffness or neurovascular compromise* The goal of surgical release is to a achieve a regional fasciectomy or subtotal fasciectomy that allows maximal untethered joint motion (568-CDT 4th)