Isifo sikaDupuytren yisifo esiqhubekayo esidala ukuguquguquka okuqhubekela phambili nokunganqamuki komunwe owodwa noma ngaphezulu wesandla. Lesi sifo esingapheli sithinta kakhulu umunwe wesine nowesihlanu. Ukuhlasela kukhubaza ngendlela enzima (lapho umunwe ugoqeke kakhulu entendeni yesandla), kodwa ngokuvamile awubuhlungu. Umsuka walesi sifo, esiqanjwe ngoBaron Guillaume de Dupuytren owasichaza ngo-1831, akwaziwa kuze kube namuhla. Ukuhlinzwa kungase kudingeke ukuze ubuyisele umunwe othintekile ekhonweni lawo lokunyakaza, kodwa ukuphindeka kuvamile.

Isifo sikaDupuytren sibonakala ngokuqina kwezicubu eziphakathi kwesikhumba kanye nemisipha entendeni yesandla ezingeni leminwe (i-palmar fascia). Njengoba iguquka (imvamisa ngokungalingani kodwa ngokungenakugwenywa), "igobisa" umunwe noma iminwe ngasentendeni futhi ivimbele ukunwetshwa kwayo, kepha hhayi ukujiya kwayo. Ukuhlehla okuqhubekayo kwezicubu kubonakala emehlweni ngokwakhiwa "kwezintambo".

Kuvamise ukuba phakathi kweminyaka engama-50 lapho kuvela khona izimpawu zokuqala zesifo sikaDupuytren. Kumele kuqashelwe ukuthi abesifazane bavame ukuthuthukisa lesi sifo kamuva kunabesilisa. Noma ngabe kunjalo, lapho ukuhlasela kusenesikhathi, kuzoba okubaluleke kakhulu.

Yonke iminwe yesandla ingathinteka, kodwa ku-75% yamacala ukubandakanyeka kuqala ngomunwe wesine nowesihlanu. (1) Siyivelakancane kakhulu, kodwa isifo sikaDupuytren singahlasela ingemuva leminwe, amathe ezinyawo (isifo iLedderhose) kanye nobulili besilisa (isifo sikaPeyronie).

Umsuka wesifo sikaDupuytren awukaziwa kuze kube namuhla. Kungaba ingxenye (uma kungenjalo ngokuphelele) yemvelaphi yofuzo, amalungu amaningana omndeni avame ukuthinteka.

Ukuphuza utshwala nogwayi kubhekwa njengento eyingozi, njengoba nje kubonakala ukuthi izifo eziningana ngezinye izikhathi zihlotshaniswa nesifo sikaDupuytren, njengesithuthwane nesifo sikashukela. Impikiswano ivusa umhlaba wezokwelapha ngokuchayeka emsebenzini we-biomechanical njengento eyingozi yesifo sika-Dupuytren. Ngempela, ucwaningo lwesayensi olwenziwa phakathi kwezisebenzi zezandla lubonisa ukuhlobana phakathi kokuchayeka ekudlidlizeni nesifo sika-Dupuytren, kodwa imisebenzi eyenziwa mathupha ayaziwa - kuze kube namuhla - njengembangela noma isici esiyingozi. (2) (3)

Izimbangela zalesi sifo azaziwa, akukho ukwelashwa okukhona kuze kube manje, ngaphandle kokuhlinzwa. Ngempela, lapho ukuhlehla kuvimbela ukunwetshwa okuphelele komunwe owodwa noma eminingi, ukuhlinzwa kuyacatshangelwa. Kuhloswe ngayo ukubuyisela ububanzi bokunyakaza emunweni othintekile kanye nokunciphisa ubungozi bokusabalala kweminye iminwe. Ukuhlola okulula ukukwazi ukubeka isandla sakho siphansi ngokuphelele endaweni eyisicaba. Uhlobo lokungenelela luncike esigabeni sesifo.

• Ingxenye yamatomu (i-aponeurotomy): lokhu kwenziwa ngaphansi kwe-anesthesia yendawo, kodwa kuveza ingozi yokulimala kwemikhumbi, imizwa kanye nemisipha.
• Ukususwa kwamatomu (i-aponevrectomy): ukuhlinzwa kuthatha phakathi kwemizuzu engama-30 namahora ama-2. Ngamafomu abucayi, ukukhishwa kwemali kuhambisana nokuxhunyelelwa kwesikhumba. Le nqubo yokuhlinzwa “enzima kakhulu” inenzuzo yokunciphisa ubungozi bokuphinda, kodwa kubi kokushiya ukulandelana okubalulekile kobuhle.

Njengoba lesi sifo siqhubeka futhi ukuhlinzwa kungaziphathi izimbangela zaso, ingozi yokuphindaphinda iphezulu, ikakhulukazi esimweni se-aponeurotomy. Izinga le-recidivism liyahluka phakathi kuka-41% no-66% kuye ngemithombo. (1) Kodwa kungenzeka ukuphinda ukungenelela okuningana phakathi nalesi sifo.

Ngemva kokuhlinzwa, isiguli kufanele sigqoke i-orthosis amasonto ambalwa, idivayisi egcina umunwe ohlinziwe unwetshiwe. Ithuthukiswa ngumelaphi wemisebenzi. Kube sekubekwa ukuvuselelwa kweminwe ukuze kubuyiselwe ukunyakaza kwayo emunweni. Ukuhlinzwa kuveza ubungozi, kuma-3% wamacala, wokudalula ukuphazamiseka kwe-trophic (i-vascularization empofu) noma i-algodystrophy. (IFCM)