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This term is applied to thickening and shortening of the palmar fascia or palmar apoueurosis.
The latter is a strong triangular sheet of tissue lying beueath the skin and fat of the palm of the liand. The apex of the sheet is at the wrist; its base lies towards the fingers and is prolonged into four strips. one of which is attached to the base of each finger. The thumb is not provided with a strip. |
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In Dupuytren's contraction the knuckle-joint suffers most flexion, for the palmar aponeurosis is attached to the first phalanx of the finger, and when it is shortened the first effect of the shortening naturally is to bend that phalanx at the knuckle-joint, leaving the other joints unaffected. Thus the other joints of the affected fingers remain movable, or, at any rate, not flexed.
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| The condition begins with the formation of one or two small hard nodules in the palm, usually in a line with the ring finger. These nodules unite to forms ridge beneath the skin, and the finger begins to be bent towards the palm. The little finger is soon involved, and later the middle and even the index finger; but the ring finger suffers first and most. |
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| DUPUYTREN'S FINGERS. The fingers are bent at the joints to the hand and extended at the joints between the phalanges or segments |
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The friction of tools against the palm, the pressure of a round knobbed walking-stick, wasting of the fat of the palm of the hands all have been given as causes of Dupuytren's contraction, without conclusive evidence. It occurs mostly in elderly men.
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