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CuRsE OF

THE viKinGs? By Dr Ashley Naidoo, a specialist

Hand and Upper Limb Surgeon
Dupuytrens Disease and Contracture: and the co-founder of the Gauteng
at Netcare Waterfall City Hospital
What you need to know Orthopaedic Institute

d upuytrens disease (or Viking TREATmEnT

Conservative
Hand, as it is commonly
known) is a condition
which has stemmed from This is usually indicated when the
joint contractures are not severe and
scandinavian origins dating back treatment entails the following:
to the early 16th century. Folklore • Hand Therapy exercises (usually
also incriminates the kinsmen of stretching and massaging); WWW.DuPuyTRENs.ORG
clan MacCrimmons in scotland • Splinting of the hand by a therapist
as to its origins. It is a benign (in the early stages of contracture);
condition (non-cancerous) wherein • Steroid injections (into
the normal palmar tissues (sheath) nodules mostly).
thicken to form nodules and cords
which eventually cause the fingers Alternative Therapies

to adopt a flexed position. • Collagenase injection (enzyme to

break down cords), though this
WHAT CAusEs iT? is not popular in south Africa;
Dupuyrens disease has a strong genetic • Radiotherapy (in early stages), though WWW.PHysIO-PEDIA.COM
inheritance especially among European- this is also not popular in south Africa.
descent males. It is currently believed Cords in palm, inability to fully extend at finger joints

that a change in the cells that make surgery

up the palm fascia causes a different surgery is required when
type of collagen to be produced that contractures affect activities of

leads to the nodules and cords. daily living and reduce dexterity. HTTPs://DuPuyTENs-sOCIETy.ORG.uk
When it comes to surgery, the
Risk Factors and Associations: following options are available:
• Genetic (European descent) • Z Plasty and Fasciectomy (a preferred hand Therapy exercises
• Males > Females option) – where the skin is lengthened,
• 40 to 70-year-olds usually and the cords are removed;
• HIV • Needle Fasciotomy - where a needle
• Alcohol is used to puncture cords via the skin
• Diabetes mellitus and manipulated until it ruptures;
• Lederhosens Disease (when • Dermofasciectomy - in older
the cords affect the feet). patients with fragile skin, the cord

and skin are removed together WWW.NEWs-MEDICAL.NET
Clinical symptoms and signs: and a skin graft is used.

• Little and ring fingers commonly
aff ected Dr Ashley Naidoo is a specialist Hand Institute and Tanya Coats Occupational
• Nodes/Nodules in palm and upper Limb surgeon at Netcare Therapy have collaborated to offer a

• Cords in palm Waterfall City Hospital and the co- specialised Hand and upper Limb unit

• Inability to fully extend at finger joints founder of the Gauteng Orthopaedic at Netcare Waterfall City Hospital. Call
• Usually painless. Institute. The Gauteng Orthopaedic 011 304 7756 to book an appointment.

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