Mr. Lu, who is 52 years old, works in the building industry and has the habit of smoking and drinking. He chiefly complains that the right little finger has been subject to flexion contracture for two years, where there used to be subcutaneous nodules in the previous three years, but he didn’t suffer from any hand injuries or other medical diseases in the past. The physical examination shows that he can clench the fist completely, but the little finger can’t be straightened (even with the help of external force). It is found by means of surgery that there is severe fibrosis and hypertrophy of subcutaneous palmar fascia at the infected part. After the excision of the infected fascia, the little finger can be straightened roughly, which proves the case is one of rare Dupuytren’s contracture. Lin Zhi-He, director of the Plastic Surgery in the Zhongxiao Branch of Taipei City Hospital, says that Dupuytren’s contracture prevails in Northern Europe, and rarely seen among easterners. The cause is still unknown, but presumably gene-related. Some people overreact to minor trauma in the palm, thus producing abnormal hyperplasia and fibrotic scar tissues in the subcutaneous palmar fascia; the contraction of scar tissues will make the finger bent. Lin Zhi-He says that the disease occurs more easily among men above 50 years old and that smoking, drinking, diabetes and HIV infection will probably increase the incidence rate. If you are among the high risk group, please seek medical care promptly when you find any subcutaneous nodules of unknown causes in the palm.
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