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How is contracture measured?
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06/29/2007 05:57
Judith_Proctor 
06/29/2007 05:57
Judith_Proctor 
How is contracture measured?

I diagnosed myself (with the aid of a good friend) with Dupytren's just over six months ago. Since then, I've been struggling to find someone who will give me radiotherapy in the UK and watching my hand get worse.

Today, I'm going to see a radiotherapist at Poole hospital - if he treats me, I'll post details for others. I think he will be willing as he was interested when we spoke a couple of weeks ago.

However, what worries me is that is that I'm not sure what stage my disease is in. My left hand has just a few small nodules - definitely a case for radiotherapy. My right hand has already suffered a degree of contracture (which is extrememly frustration as there was no contracture when I first worked out what the lumps on my hand were). I've lost about 10 degrees of movement, which would seem to make this hand borderline for successful radiotherapy.

However, I'm hypermobile and a loss of 10 degrees for me still means that I can bend my fingers backwards by around 20 degrees when my hand is placed flat on a table.

Is the degree of contracture measured from the original flexilility of the hand, or is it contracture from a hand with all the fingers held in a straight line with the palm?

If it is the latter, then I may have a lot less to worry about.

06/29/2007 06:57
wach 

Administrator

06/29/2007 06:57
wach 

Administrator

Re: How is contracture measured?

Judith, I am not an expert on measuring stages but I would assume that the measurement is how big the deficit relative to "straight" is. I don't think that it is measured relative to bending backwards, at least that is what I would think.

With a slight extension deficit radiotherapy might still be helpful to slow down or stop further progression. It most likely won't be able to remove the extension deficit and it will not dissolve the cord. Radiotherapy works best on nodules.

If the hospital is interested in more details about the therapy we can provide copies of research papers and a description of the usual treatment. It's not yet standardized and research is on-going to minimize the total dose but there is ágreement on what is currently being used and how it is administered.

Good luck!
Wolfgang

06/29/2007 11:19
Judith_Proctor 
06/29/2007 11:19
Judith_Proctor 
Re: How is contracture measured?

The radiotherapist will be using the dosage recommeneded on your web site. (as electrons)

He's starting treatment on Monday.

I think I was lucky to find a radiotherapist who is already used to treating non-malignant growths with radiotherapy.

If the treatments prevents further progression of the disease, then I will be happy. I haven't lost much use in my right hand yet and the cords have not yet started in my left.

My main concern was where I fell in the treatment categories - whether I count as N or N/I or I. Success depends on the stage you are at when treatment starts. My left hand is definitely N, so I have good expectations there. Depending on how the contracture is measured, I am either N/I or I with my right hand. If I am I, then the treatment only has a low chance of success. If I'm N/I, then the prospects are still good and the disease progression may be halted.

06/30/2007 07:26
TrevB 
06/30/2007 07:26
TrevB 

Re: How is contracture measured?

Quote:



Today, I'm going to see a radiotherapist at Poole hospital - if he treats me, I'll post details for others. I think he will be willing as he was interested when we spoke a couple of weeks ago.



Is that Poole in the UK?

06/30/2007 08:29
Judith_Proctor 
06/30/2007 08:29
Judith_Proctor 
Re: How is contracture measured?

Yes, Poole, Dorset, UK.

06/30/2007 11:09
TrevB 
06/30/2007 11:09
TrevB 

Re: How is contracture measured?

Quote:



Yes, Poole, Dorset, UK.



Interesting stuff Judith. I'm in Cambridgeshire although I might be coming down next Weds for the speedway If you do get the chance at any point, would you mind asking if he's got any contacts in this area of the country working on treating non-malignant growths with radiotherapy? Otherwise just keep us informed on your experiences - good luck


Edited at 06/30/07 14:12

07/01/2007 06:05
newman 
07/01/2007 06:05
newman 

Re: How is contracture measured?

Quote:



Hi from down under .To monitor any contracture simply place your hand on a flat table whilst being seated, with the palm facing upwards and fingers outstretched ,with the use of a ruler or micrometer record the measurement from the table surface to the area on the finger above the finger nail. Ideally all finger nails will be in contact with the surface of the table. Hope this may help. Adelaide .South Australia.

07/01/2007 06:05
newman 
07/01/2007 06:05
newman 

Re: How is contracture measured?

Quote:



Hi from down under .To monitor any contracture simply place your hand on a flat table whilst being seated, with the palm facing upwards and fingers outstretched ,with the use of a ruler or micrometer record the measurement from the table surface to the area on the finger above the finger nail. Ideally all finger nails will be in contact with the surface of the table. Hope this may help. Adelaide .South Australia.

07/01/2007 06:19
Judith_Proctor 
07/01/2007 06:19
Judith_Proctor 
Re: How is contracture measured?

I thought contracture was normally measured in degrees, not as a linear measurement?

Still, if it is done from a flat position, then I'm in with a good chance as I can still hold the hand flat back on a table.

07/10/2007 08:31
newman 
07/10/2007 08:31
newman 

Re: How is contracture measured?

Hi Judith Proctor Australia calling.Just to confirm the advice given to me on how to measure contracture. Prof Albert Hofmann from Klinik Rosengasse Ulm Germany has a website. Quote " when the mearsurement taken from the finger nail to a flat surface with palm facing up exceeds 5 to 6 cms. ( 2 inches) the an operation is necessary "Hope this helps. Barry.

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mearsurement   measurement   measured   successful   treatment   expectations   hypermobile   degrees   recommeneded   administered   contracture   radiotherapist   standardized   outstretched   Cambridgeshire   flexilility   radiotherapy   progression   non-malignant   interested