Digital neuropathy of the median and ulnar nerves caused by Dupuytren's contracture: Case report.
BACKGROUND
Digital neuropathy is a pure sensory neuropathy of a digital nerve. It may be caused by acute or chronic local trauma or pressure, or accompany systemic illnesses such as rheumatoid disease, leprosy, Raynaud disease, dysproteinemia, or diabetes mellitus. We describe an extraordinary case of digital neuropathy of the median and ulnar nerves caused by Dupuytren contracture.


METHODS
A 56-year-old right-handed man was presented with numbness and tingling of the little finger of the right and ring finger of the left hand. The clinical and EMG findings in this patient were consistent with a lesion of the median and ulnar palmar digital nerves of the right and left ring and little fingers.


CONCLUSIONS
Dupuytren tissue usually affects the palmar fascia, superficial to the digital nerves, and it may rarely affect the spiral cord in the digits. A spiral cord may cause sensory loss due to impingement of digital nerves or Dupuytren tissue may have been compressing the palmar digital nerves against the relatively inelastic deep transverse metacarpal ligament. As a result, digital neuropathy can develop in those with Dupuytren's contracture, and nerve conduction studies should also be performed to determine the condition. New studies are needed to provide better diagnostic criteria for the condition.
Guney
Figen
F
Department of Neurology, University of Selcuk, Konya, Turkey. guneyfigen@yahoo.com.tr
Yuruten
Betigul
B
Karalezli
Nazim
N
D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use; D002220:Carbamazepine / Q000494:pharmacology / Q000627:therapeutic use; D004387:Dupuytren Contracture / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D004568:Electrodiagnosis; D005205:Fascia / Q000473:pathology / Q000503:physiopathology; D005385:Fingers / Q000294:innervation / Q000503:physiopathology*; D005938:Glucocorticoids / Q000494:pharmacology / Q000627:therapeutic use; D006225:Hand / Q000294:innervation / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D020423:Median Neuropathy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D010349:Patient Compliance; D016896:Treatment Outcome; D014221:Triamcinolone / Q000494:pharmacology / Q000627:therapeutic use; D014459:Ulnar Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D020424:Ulnar Neuropathies / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*
D000927:Anticonvulsants; D005938:Glucocorticoids; D014221:Triamcinolone; D002220:Carbamazepine