Metabolic Disorders

Dupuytren's contracture

Dupuytren's contracture is a hereditary thickening of the tough tissue that lies just below the skin on the palm of a hand. This condition may vary from small lumps or bands to very thick bands, which may eventually pull the fingers into the palm. Surgery is the only form of treatment for Dupuytren’s contracture, and is particularly recommended if there is a progressive contracture that is drawing the fingers into the hand. Even with successful surgical removal, the bands may reappear or occur in other fingers.

Trigger finger

Trigger finger is a thickening of the sheath around the tendon over time. This causes the sheath to become narrow and impairs the passage of the tendon through the sheath, which in turn causes catching, snapping or popping of the finger. Sometimes the thickening can be treated with rest or steroid injections. The tendon sheath will then return to its normal, pain-free condition. However, more severe cases may require surgery to release the tendon. This can be done as an outpatient procedure.

De Quervain's tendinitis

De Quervain's tendinitis involves tenderness, swelling and pain in the wrist radiating into the forearm and the thumb. It can be caused by calcium deposits, repeated strain or trauma, rheumatoid arthritis or gout. It is most common in new mothers caring for their babies, and in some patients doing forceful pinch activities. The condition is similar to trigger finger. Diagnosis of de Quervain's tendinitis is based on the location of the patient's pain and the presence of swelling in the hand and decreased hand function. If treated early, many cases of de Quervain's tendinitis improve with rest in a splint, injection with steroids and/or taking anti-inflammatory medications and gradual exercise.

Gouty hand deformity

Gout, also called crystal-induced arthritis, is an arthritic condition that occurs when uric acid crystals accumulate in the joints. Gout usually affects the large joint of the big toe, but can also affect other joints, such as the hand, wrist and elbow. For people with gout, the uric acid level in their blood is so high that uric acid crystals form and deposit in joints and other tissues. This causes the joint lining to become inflamed, resulting in sudden and severe attacks of pain, tenderness, redness and warmth.

Chronic gout can damage the cartilage and bones. After several years, the crystals can build up in the joints and surrounding tissues, forming large deposits, called tophi. Tophi look like lumps under the skin and are often found in or near severely affected joints, on or near the elbow, and over the fingers. The hand surgeons at Henry Ford can help treat gout, including surgery to help repair any possible deformities caused by gout.

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