Dupuytren’s Contracture: NEET PG High-Yield
Fibromatosis: Palmar Fascia Disorder
1. Pathophysiology
A fibroproliferative disorder of the palmar fascia resulting in progressive nodule formation and contracture bands. The process is characterized by an excessive deposition of type III collagen and myofibroblast proliferation.
2. Clinical Features
- Most Common Site: Ring finger (4th digit), followed by the little finger (5th digit).
- Classic Presentation: Initially presents as a firm, painless nodule in the palm, followed by the development of longitudinal cords that cause fixed flexion contractures at the MCP and PIP joints.
- Epidemiology: More common in males, Nordic/Northern European descent, and older age groups.
3. NEET PG Examination Pearls
| Association | High-Yield Detail |
|---|---|
| Associated Conditions | Peyronie’s disease (penis), Ledderhose disease (plantar fascia), and Garrod’s pads (knuckle pads). |
| Diagnosis | Tabletop Test: Inability to place the palm flat on a table due to the contracture. |
| Management | Needle fasciotomy (for early stages), Collagenase injections, or limited fasciectomy (for severe/recurrent cases). |