Abstract:
Introduction. Dupuytren Contracture is a pathological thickening of the skin in the palm and at the base
of the proximal phalanges, which develops into a hard knot or retractile band. Over time, it can lead to one
or more fingers to contract irreversibly. Carpal Tunnel Syndrome is an abnormal hand condition that is
caused by pressure on the median nerve in the radiocarpal joint. This can lead to symptoms such as
paresthesias, numbness and loss of sensitivity in the hand, wrist and arm. Dupuytren Contracture is treated
by fasciotomy, fasciectomy, percutaneous aponeurotomy or enzimatic injections, while the surgical
treatment for Carpal Tunnel Syndrome is decompression of the transverse carpal ligament. These two
diseases can have similar symptoms, but they are caused by different factors and may require different
treatments.
Case presentation. In the Hospital of Orthopedics and Traumatology, march-august, 2021, underwent
partial fasciectomy 2 patients with Dupuytren Contracture, grade II-III, which after 2 months were
complicated by the Carpal Tunnel Syndrome, ultrasonographically confirmed - the median nerve with
inflammation signs along the path, the common synovial vagina of the flexors dilated. There was performed
decompression of the transverse carpal ligament, with neurolysis of the median nerve. Currently, both
patients do not mention recurrences.
Discussion. Dupuytren Contracture has unknown etiology. All over the world, there is no single principle
to define it, but it is supposed to be caused by repetitive trauma, genetics, smoking, diabetes, alcoholism,
liver pathologies, etc. Carpal Tunnel Syndrome can manifest, also, after trauma, surgery or other
inflammatory processes. The literature is conflicted in regard to these conditions as a consequence after
intervention for common pathologic conditions of the hand, as well as regarding their management. There
are not so many cases in our experience when Dupuytren Contracture is complicated by Carpal Tunnel
Syndrome, worldwide it has a 4,6% incidence.
Conclusion. Inflammation caused by surgery for Dupuytren Contracture was the first causative trigger for
the onset of the Carpal Tunnel Syndrome. Also, during these 2 months wearing the splint and performing
exercises that represented repetitive movements in the radiocarpal joint, were the factors that contributed
to the evolution of the disease.
