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Arthritis und Rheuma 2008; 28(04): 213-218
DOI: 10.1055/s-0037-1620118
Diabetes und Rheuma
Schattauer GmbH

Dupuytrensche Kontraktur und diabetische Cheiropathie

Dupuytren’s contracture and limited joint mobility
A. Braun
1   Bethanien Krankenhaus Heidelberg, Geriatrisches Zentrum am Klinikum der Universität Heidelberg (Chefarzt: Prof. Dr. Peter Oster)
,
T. Neumann
2   Friedrich-Schiller-Universität Jena, Klinik für Innere Medizin III (Direktor: Prof. Dr. Gunter Wolf), Rheumatologie/Osteologie (Leiter: Prof. Dr. Gert Hein)
,
G. Hein
2   Friedrich-Schiller-Universität Jena, Klinik für Innere Medizin III (Direktor: Prof. Dr. Gunter Wolf), Rheumatologie/Osteologie (Leiter: Prof. Dr. Gert Hein)
,
P. Oster
1   Bethanien Krankenhaus Heidelberg, Geriatrisches Zentrum am Klinikum der Universität Heidelberg (Chefarzt: Prof. Dr. Peter Oster)
› Author Affiliations
Further Information

Publication History

Publication Date:
24 December 2017 (online)

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Zusammenfassung

Die Dupuytrensche Kontraktur (Morbus Dupuytren, [MD]) tritt gehäuft bei Menschen mit Diabetes mellitus auf und gehört zusammen mit der diabetischen Cheiropathie (DC) zu dem sogenannten diabetischen Handsyndrom. Die Prävalenz eines MD liegt in den westlichen Industrienationen bei ein bis drei Prozent, weltweit variiert sie zwischen zwei und 42 Prozent. Als wichtigste ätiologische Faktoren wer-den neben dem Diabetes mellitus alkoholtoxische Leberschäden, ethnische Prädispositionen und die kontrakturauslösende Wirkungvon Traumen imBereich derHohlhand diskutiert. Im folgenden Artikel werden Diagnostik, Differenzialdiagnostik und Besonderheiten der Therapie des MD und der DC bei Menschen mit Diabetes besprochen. Bei der lokalen Applikation von Kortikoiden sollte die mögliche Erhöhung der Blutglukosewerte bedacht werden und gegebenenfalls eine Intensivierung der Diabetestherapie erfolgen. Da große Studien und überzeugende Langzeitergebnisse zu konservativen Maßnahmen ausstehen, ist die operative Therapie weiterhin ein etabliertes und effektives Standard-verfahren zur Behandlung des MD.

Summary

Dupuytrenś disease (MD) occurs frequently in patients with diabetes mellitus and is considered to be part of the diabetic hand syndrome together with other syndromes, such as the limited joint disease (DC). The prevalence of MD is estimated to be 1 to 3% in western industrial nations and 2 to 42% worldwide. Besides diabetes mellitus, most important aetiological factors are alcoholic liver damages, racial factors and contracture triggering effects due to trauma in the palm of the hand. This paper describes the diagnostics, differential diagnostics and specialities regarding the therapy of patients with both MD and diabetes. Also in case of local application of corticoids, one should consider the continuing elevation of bloodglucose levels with potential need of the intensification of diabetes therapy. As currently convincing study results of conservative treatment strategies are not available, surgery is still an effective and established standard treatment of MD.

Schlüsselwörter

Diabetes mellitus - diabetische Cheiropathie - Dupuytren - Kontraktur - diabetisches Handsyndrom

Keywords

Diabetes mellitus - Dupuytren - contracture - diabetic hand - limited joint disease
 

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