The Claw Hand

Dupuytren’s Contracture the Claw Hand Disease.

Dupuytren’s disease is a progressive, sometimes painful, and frustrating condition.

The history, diagnosis, treatment, and outcome of Dupuytren’s can vary from one person to another.

A person looks at his hand palm up and forms his hand into a claw. He pays particular attention to his fingers and the feel of the tendons, ligaments, and muscles as he forms a claw. He imagines that this is happening to him over time. He has no control over it and cannot stop it. He, unlike people with Dupuytren’s disease, can straighten out his hands. I have a history of Dupuytren’s in both of my hands.

History says that Dupuytren’s Contracture originated with the Vikings, who spread it throughout Northern Europe and beyond as they plundered, raped, settled, and intermarried. Scientists are not sure why the Viking origin predisposes people to suffer from Dupuytren's. (1) It is estimated that, in 70% of cases, people have a predisposition to Dupuytren’s. need citation here (2) There are no screening procedures such as DNA, laboratory tests or other diagnostic tests. It is hoped that, with the aid of DNA, scientists will come up with a screening test. Millions of people suffer from Dupuytren’s today. However, Guillaume Dupuytren first described the disease in the nineteenth century. (1)

Baron Guillaume Dupuytren (October 5th, 1777 – February 8th, 1835) was a French anatomist and military surgeon. He is best known today for Dupuytren's Contracture, which is named after him. He performed the first of many corrective surgeries in 1831. (3), see Figure 1

Figure 1

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Damage from the disease is slow, chronic, painful, and debilitating with no known cure. There are many treatment options available depending on the severity and the stage of the disease once the diagnosis is made. After surgery, the real work of occupational therapy begins to restore as much function to the fingers as possible. The 50% recurrence rate of Dupuytren's is upsetting to patients because additional treatment may be needed.

The patient must hope to retain function for daily activities and work. The possibility of long-term disability is high and may cause the patient to go on some kind of disability assistance in the near future.

After surgical interventions and extensive treatment, it can be difficult to see a future in a profession like nursing. Nursing requires more manual dexterity than I may ever recover in either one of my hands.