$Unique_ID{BRK00554}
$Pretitle{Musculoskeletal System and Connective Tissue, Ill Defined Symptoms
and Rare Diseases}
$Title{Bumps in the Palm of the Hand}
$Subject{Dupuytren's fingers contraction}
$Volume{M-18, N-18}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Bumps in the Palm of the Hand


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QUESTION:  Over a long period of time, my hand has developed small hard bumps
in the palm, and I can no longer open my fingers completely.  I remember my
Dad had a similar problem, but I can't remember the name the doctor gave to
condition.  Can you tell me the name of the condition, and how to go about
getting it cured?

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ANSWER:  Your description of your hand allows me to be reasonably sure of the
diagnosis, which is called Dupuytren's Contracture.  It generally is more
frequent in men than women, starts its course around the age of 50 or 60, and
progresses slowly.  It is not painful, and the bumps you feel are not tumors
and never turn into cancer.  They are, rather, nodules of fibrous tissue, that
form in the sheet of tissue that lies between the skin and the tendons,
(called the palmar fascia).  The sheet of tissue becomes shortened, pulling on
the fingers and causing them to curl.  Usually it is the ring finger and the
little finger that is most affected.  It is known to be inherited,
particularly in people of Irish, Scotch or Scandinavian descent, and although
it was first described more than 150 years ago by the French physician,
Dupuytren, the cause of the disease is still unknown.  Many medical treatments
have been tried, including injections of steroids, as well as diet and
exercises, but none have met with any real success.  The recommended treatment
is the surgical removal of the affected tissue.  While the operation may seem
straight forward, it is complicated by the presence of many small nerves and
arteries, and requires a skilled hand surgeon to perform the operation.  The
postsurgical period is most important, with the hand kept immobile for about a
week, followed by regular exercises to regain mobility and function.  Since
the condition may continue to progress, some patients require this operation
on more than one occasion, but the earlier the treatment is started, the
better the results will be.  You should certainly be seen by a surgeon at this
time, for confirmation of my impression, and to get your own therapy started.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
