What is Capsular Contracture and the Rippling Effect?

by Dr. Jim Greene

A condition which can affect those of Scandinavian descent after the age of 40 leaving them with an inability to extend their pinky, ring and middle finger of just one or even both hands is known as Dupuytren’s contracture. In this condition, the tendons which run from all the joints in the fingers are connected near the wrist and do most of their contractions under the skin of the palm. However, this skin can become thickened on the underside between the skin layers and the bone much like a callous. As it becomes thicker, this callous of scar tissue under the layers of skin can become entangled in the tendons preventing their ability to fully extent the pinky, ring and middle fingers.

Between the ages of 40 and 80 years of age, those who have been genetically predisposed of being able to suffer from Dupuytren’s contracture may already be developing the condition without ever knowing it. In general, this condition hits those of Scandinavian descent especially those descendant of the Vikings.

The only real option for treatment of Dupuytren’s contracture is surgery. This surgical procedure usually entails both the palm of the hand as well as the affected fingers. In the case of the palm of the hand, the hand will be opened up allowing the surgeon to clean away the scar tissue that has found its way entangled between the tendons. After which the surgeon may also opt to make a series of incisions on the inside of the knuckles of the affected fingers as a means of making the skin looser so that the fingers can move more freely.

It is important to have this condition properly diagnosed as there is a very similar condition which is caused by a completely different form of trauma. Volkmann’s contracture which appears to be similar to that of Dupuytren’s contracture is actually caused by trauma to the forearm. The ending results is shortened tendons from the forearm to the finger tips. Persons who have Volkmann’s contracture can extend their fingers, but only when the writ is bent inwards, where as those with Dupuytren’s contracture cannot.

The chances of this occurring increase drastically on persons over the age of 40 and who are of Scandinavian descent. This condition can often be remedied through a particular surgical procedure which loosens up and removes some of the scar tissue surrounding the tendons in the palm of the hand.

The only other related arm contracture is Volkmann’s. This contracture does resemble Dupuytrens contracture. The causes of the two are very different however. Both can be remedied by a surgical procedure.

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