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The main function of the palmar fascia is to increase grip strength; thus, over time, Dupuytren's contracture decreases a person's ability to hold objects and use the hand in many different activities. Dupuytren's contracture can also be experienced as embarrassing in social situations and can affect quality of life. [15]
Dupuytren's contracture Guillaume Dupuytren, Baron Dupuytren ( UK : / ˌ dj uː p w iː ˈ t r æ̃ , dj uː ˈ p w iː t r ɛ n / , [ 1 ] US : / d ə p w iː ˈ t r æ̃ , d ə ˈ p w iː t r ən / , [ 2 ] French: [ɡijom dypɥitʁɛ̃] ; 5 October 1777 – 8 February 1835) was a French anatomist and military surgeon .
In adjunct with surgery, refractory muscle contracture can also be treated with Botulinum toxins A and B; however, the effectiveness of the toxin is slowly lost over time, and most patients need a single treatment to correct muscle contracture over the first few weeks after surgery. [21] Shortening of the surgically lengthened muscle can re-occur.
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Many of these deformities, such as Dupuytren's contracture, swan-neck deformity etc. can be associated with both a chronic, progressive event, or an acute injury; [17] such as boutonnière deformity, which can be caused by trauma, [1] or induced by a chronic condition like rheumatoid arthritis. [20]
Hand injuries when not treated on time can result in long term morbidity. [6] Simple hand injuries do not typically require antibiotics as they do not change the chance of infection. [7] Many hand injuries need surgery, but the time from injury to surgery (delays of up to 4 days) doesn't increase the chance of infection [8]
The overlying skin is freely movable, and contracture of the toes does not occur in the initial stages. [6] A plantar fibroma right below the 2nd toe. The typical appearance of plantar fibromatosis on magnetic resonance imaging (MRI) is a poorly defined, infiltrative mass in the aponeurosis next to the plantar muscles. [7]
Knuckle pads are benign subcutaneous fibrotic nodules that are seen in the finger joints and/or the extensor area of the foot. [6] [7] [8] From a clinical perspective, these are well-defined, non-compressible, freely moveable lesions that resemble warts and primarily affect the dorsal portion of the proximal interphalangeal (PIP) and, less frequently, the metacarpophalangeal (MCP) joints.
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