Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a progressive, painless thickening of the palmar fascia in the right hand. Reports development of palpable nodules and subsequent cord formation leading to digital flexion contracture. Patient notes difficulty with hand extension, gripping objects, and performing activities of daily living. No history of acute trauma or recent infection.
Clinical Examination Findings
Physical examination of the right hand reveals palpable subcutaneous nodules and longitudinal fibrous cords extending into the digits, most prominently involving the [MCP/PIP] joints. Hueston tabletop test is positive. Digital extension is limited by [X] degrees at the [digit] joint. Neurovascular status is intact with no signs of digital ischemia or nerve compression.
Treatment Protocol
Treatment plan discussed: Options include observation for mild cases, collagenase clostridium histolyticum injection, needle aponeurotomy, or limited fasciectomy. Risks and benefits of surgical intervention versus minimally invasive procedures reviewed. Post-procedure splinting and hand therapy protocol initiated to maintain range of motion.