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.
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