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    Hands: Dupuytren's Disease (lump in palm)

    18-Jun-2010
    By

    I've been climbing for 30 years and just noticed a lump forming in the palm of each hand between the bones that extend down from my ring fingers and pinkies. The lump doesn't hurt but it looks like somebody slipped a peanut into my hand. WTF?

    Jeff Jacksom, Basalt, Colorado

    In the mid 9th century, the Vikings got around, albeit in a less than gentlemanly manner. Visiting the neighboring shores across the North Sea, Scotland, Ireland, England, yada yada, they raped, pillaged and plundered to their hearts' content. Wreaking havoc on your neighbors was apparently a great tonic.

    Though the genes for blue eyes and blond hair has its advantages, the full Viking genome does not come with a lifetime warranty. It carries a pesky piece of DNA that causes Dupuytren's disease (DD), defined by the formation of scar tissue in the palm of the hand -- more specifically, in the fascia underlying the skin.

    DD is purportedly associated with many other diseases: alcoholism, epilepsy, AIDS, diabetes, hepatic disease, fibromatosis, peptic ulcers, myocardial disease, carpel-tunnel syndrome, trigger finger, one ear lower than the other, or your mother predominantly calls on a Tuesday. Because DD has an onset in the middle to later ages, for many it is more likely a coincidental association only. Fact: most of the afflicted are males aged over 35, of Anglo descent.

    Splints, heat, cortisone, electro gizmos, vitamin E, etc., are all uniformly and categorically unsuccessful.

    Needle aponevrotomy is the most significant advance in DD management in recent decades. The Dupuytrens cord is weakened and cut with a #25 gauge needle. Relax! It is quite small. Simple, quick and comparatively cheap, the procedure will cost you about 650 bingo bets per finger. Like surgery, recurrence is as high as 50 percent. Unlike surgery, it can be repeated and has very little rehab. One physician, regarding recovery, says,

    Close to 100 percent could return to climbing within two weeks after the procedure. SOLD. That is, if you can get to one of the handful of physicians in the USA who are qualified to do it.

     

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