Duputrcn's contracture is seen in
(B) (Palmer fascia) (338 343 Apley 8th) (567 -68 CDT - orthopedics 4th)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 of little fingers, sometimes the dorsal knucle pads one thickened (Garrod's pad), nodules on he soles 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 for extension is common* Treatment of choice - subtotal fasciotomy *** Complete faciectomy is usually unnecessary and fraught with complication* 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 fascioctomy that allows maximal untethered joint motion (568-CDT 4th)
Leg muscle
Palmer fascia
Planter fascia
Cremester fascia
Hand Injuries