Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about Jupiter's Contracture. And you can find written notes on this topic at

0.0.2.com slash Jupitrons or in the orthopedic section of the zero definals surgery book.

So let's get straight into it.

Jupiter's contracture is a condition where the fascia of the hand becomes thickened and tight,

leading to finger contractures.

A contracture is a shortening of the soft tissues leading to restricted

movement in a joint. In Jupiterin's contracture, the finger is tightened into a flexed position

and cannot fully extend. Let's start with the pathophysiology.

The palmer fascia of the hand forms a triangle of strong connective tissue on the palm.

In Jupiter's contracture, the fascia of the hands become thicker and tighter and develop nodules.

Chords of dense connective tissue can extend into the fingers,

pulling the fingers into flexion and restricting their ability to extend. It's unclear why the

fascia becomes thicker and tighter. It's thought to be an inflammatory process in response to

micro trauma. So what are the risk factors?

The key risk factors are increased age, a family history and there seems to be an autosomal

dominant pattern, male gender, manual labour, particularly with vibrating tools, diabetes, more with type 1 but also with type 2

diabetes, epilepsy, and smoking and drinking alcohol. So how does it present? The first sign of

Duptchon's contracture is the development of hard nodules on the palm of the hand. There may be skin

thickening and pitting of the skin. Slowly the fascia becomes thicker and the finger is

pulled into flexion. It becomes impossible to fully extend the affected finger. On examination,

a thick nodular cord can be palpated from the palm

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