I agree with Douglas. While I would much prefer that this condition
responded well to techniques of connective tissue stretching and/or neural
mobilization, it does not.
My ring finger on the involved hand progressively grows slimmer as the
disease progresses and I've had the ring resized twice. Now I see that it
needs it again. At the very least, this provides me with a graphic example
of resultant compression from tensional forces, one of the more important
components of neural tension theory.
Barrett L. Dorko P.T.
<http://qin.com/dorko>
Now also at <http://www.rehabedge.com>
-----Original Message-----
From: Douglas M. White <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Friday, September 10, 1999 7:13 AM
Subject: Re: Numbness and Dupuytren's contracture
>David:
>
>I am glad you obtained such a good result with your treatment. I would
suggest
>that this is the rare exception as the literature indicates that
conservative
>treatment is not successful and the appropriate treatment is surgical
release.
>>From what you describe it appears that there was either something
different from
>Dupuytren's going on or pathology in addition to the Dupuytren's.
>
>Ric:
>
>With digital nerve involvement I would promptly refer this patient to a
hand
>surgeon.
>
>
>David Felhendler wrote:
>
>> Hi Ric,
>>
>> > Has anyone come across the standard symptoms (nodules, dermal pits,
cords,
>> > ) being accompanied by numbness of the affected fingers/palm region?
>>
>> Yes I did once and in that case it seemed to be due to decreased
>> neurodynamics of the ulnar nerve.
>>
>> > Given what's happening at the affected level in the hand, it would seem
to
>> > make sense that this may sometimes be an associated change.
>> >
>> > Any ideas about whether this should be a matter for concern/prompt
>> > treatment etc.?
>>
>> In the case I saw I started out with mobilising the cervical spine, then
>> I gently mobilised the ulnar nerve using ULTT 3 (ad modum Butler). I
>> finished of with some mobilisations with movement (ad modum Mulligan)
>> for the MCP, DIP and PIP.
>>
>> The result was very positive since not only the numbness dissappaered
>> but the ROM increased significantly.
>>
>> Regards,
>>
>> David Felhendler, P.T.
>
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|