Dupuytren's disease is a fibroproliferative condition that affects the connective tissues of the palm of the hand and fingers. The disease progresses slowly over time and is characterized by the formation of fibrous tissue in the palmar aponeurosis and fingers and causes progressive and irreversible retraction of the palmar aponeurosis.It occurs especially in people over 40 years, but it can also occur in young people. Finger IV and V are the most commonly affected, the thumb may also be involved, it may affect two digital rays simultaneously or it may appear on both hands.

The etiology of the disease is not known exactly, but there are a number of factors that may increase the risk of developing Dupuytren's disease:

• alcoholism

• diabetes

• epilepsy

• trauma

• age over 50 years

• male sex (men are more affected than women)

• family history of Dupuytren's disease

The disease begins with the appearance of a lump in the palm or at the base of the fingers, and then due to the thickening of the fascia, the cords and bands develop along the digital rays, which will cause stiffness and contracture of the fingers. In the more advanced stages, Dupuytren's disease can cause joint retractions and limit the ability to use the hands.

One of the most used classifications of the disease is the Tubiana classification:

• stage 1 - deformation between 0 and 45 degrees

• stage 2 - deformation between 46 and 90 degrees

• stage 3 - deformation between 91 and 135 degrees

• stage 4 - deformation between 136 and 180 degrees

The more advanced the stage of the disease, the more difficult the operation and recovery will be.

The diagnosis of Dupuytren's disease is established after the consultation, during which the specialist will examine your hand, observe the nodules and cords in the palm, will determine the degree of the disease and no other further investigations. Also at the time of the consultation you will be presented in detail all the treatment methods in case of Dupuytren's disease.

The treatment of Dupuytren's disease is individualized and is determined by the severity of the disease, other strongly associated, the patient's age, profession, etc. and aims to restore the functionality of the hand.

Treatment options for Dupuytren's disease include:

• non-surgical treatment

• surgical treatment

Non-surgical treatment (without surgery) can be performed by:

• needle-percussed fasciotomy (percutaneous aponeurotomy) - is performed with local anesthesia and involves the insertion of a special needle into the skin to stretch the fibrous cords; the procedure can be performed on several digital rays simultaneously, but in certain areas of the fingers it cannot be performed so as not to damage nerves or tendons.

• enzymatic fasciotomy with Clostridium Histolyticum - is one of the most modern treatments and consists in injecting the enzyme at the level of the flange / flanges that affect the fingers. The enzyme is waited for 24 hours to act, and the next day under local anesthesia, the finger is stretched, the results being immediate.

Surgical treatment (partial or total aponeurectomy) is used in the advanced stages of the disease and consists of an incision in the skin followed by the removal of part or all of the modified aponeurosis and skin suture. Postoperatively, it is recommended to follow a physiokinetotherapy program for a complete recovery of the hand.

In the absence of treatment the disease progresses and severely affects hand function and work capacity.