Dupuytren’s Contracture – its Relation to ManualWork and Vibrations

Overview

The authors submit a review on the contemporary state of knowledge as regards Dupuytren’s contracture (DC) – on theetiopathogenesis, morphology, treatment and prognosis of the disease. The findings ensuing from investigations published abroadare compared with the results of the authors’ own investigations of a group of 121 miners of the Ostrava and Karviná region wherein 1988 occupational nervous and vascular diseases of the upper extremities caused by work with vibrating tools and equipmentwere reported. The group was checked in 1993 and 1998, further examinations are planned in the course of 2003. The incidence ofthe disease correlated with the patients’ age, in the group under 42 years it was sporadic, after ten years it was more numerous ascompared with the examination after five years. Subjectively the disease was evaluated as asymptomatic, the patients’ complaintswere ascribed in particular to the basic nervous and vascular disease. In patients with a diagnosed traumatic vasoneurosis thesubsequent development of DC was more frequent than in the group of patients with nervous affections of the extremities, while bothgroups had in their occupational history exposure to supra-limit vibrations and excessive overloading of the upper extremities.Bilateral affections predominated (63%), the remaining unilateral affections were always on the side of the dominant upperextremity. The examination of the group was originally focused in particular on affection of the vascular and nervous apparatus ofthe upper extremities, investigation of DC was not a priority and for evaluation of the findings some important data are lacking; nocomparison with a reference group is available. The results of the examination support the theory on a possible causal relationshipbetween the development of DC in workers exposed to vibrations.

Key words:
Dupuytren’s contracture, palmar aponeurosis, exposure to vibrations, manual work