Hand and Wrist

The hand and wrist are made up of many different bones, muscles and ligaments that enable a wide range of movements to perform many functional capabilities.

Your wrist is made up of eight small bones known as the carpal bones. These bones support and give your wrist flexibility, and connect your hand to the two long bones in your forearm known as the radius and the ulna.

The eight carpal bones can be grouped into 2 groups: the upper and lower area of the wrist

  • Upper area (closer to the wrist): Pisiform, Triquetrum, Scaphoid and Lunate
  • Lower area (closer to the hand): Trapezium, Trapezoid, Capitate and Hamate

 

Each finger consists of a metacarpal bone and 3 phalanges, while each thumb consists of one metacarpal bone and two phalanges.

Dupuytren’s Contracture

WHAT IS DUPUYTREN’S CONTRACTURE?

Dupuytren’s Contracture is a condition in the hand where the 2 fingers furthest away from the thumb cannot be straightened completely and are bent toward the palm. This condition affects the fibrous layer of tissue that lies underneath the skin of your palm and fingers, known as fascia.

Over time, the fascia thickens and causes one or more fingers to be pulled into a bent position.

WHAT ARE THE SYMPTOMS OF DUPUYTREN’S CONTRACTURE?

Dupuytren’s Contracture develops slowly, over a period of years. Some symptoms include:

  • Thickening of the skin on the palm
  • Formation of a bump or lump on the palm
  • The fingers furthest away from your palm (last 2 fingers) are pulled toward your palm in a bent position. Occasionally, the middle finger is affected.

WHAT ARE THE CAUSES AND RISK FACTORS OF DUPUYTREN’S CONTRACTURE?

The causes of a Dupuytren’s Contracture are unknown. However, some risk factors of Dupuytren’s Contracture include:

  • Age

People aged 50 and above have a higher risk

  • Gender

Men have a higher risk

  • Family history
  • Medical conditions such as diabetes increase your risk
  • Ancestry

People of Northern European descent have a higher risk

 

WHAT IS THE DIAGNOSIS OF DUPUYTREN’S CONTRACTURE?

A history of the injury and a physical examination of the hand will be conducted by the Doctor. He will check if there are any lumps or bumps in your palm and check on the range of motion of your fingers and thumb.

WHAT ARE THE TREATMENT OPTIONS FOR DUPUYTREN’S CONTRACTURE?

Should you find that you are still able to perform everyday activities without much pain and problem, you do not need to seek treatment for your Dupuytren’s Contracture. Should treatment be required, nonsurgical treatment options include:

  • Steroid injections such as corticosteroid injection to reduce inflammation and pain
  • Enzyme injections such as Xiaflex to soften and weaken the cord that is causing contraction to the finger(s)
  • Needling to puncture the cord that is causing contraction to the finger(s)

 

Should nonsurgical treatment options be ineffective, or if the cord is interfering with your everyday activities, surgery may be recommended. Usually after surgery, physiotherapy will be required to help you regain strength and restore your range of motion.

 

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