{"text":"NHS Confidential: Personal data about a patient \nDepartment of Trauma & Orthepaedics ' N H s \nGlasgow Royal Infirmary . N, e\u2019 \n84 Castle Street \nI - e e e e -_,..a_':\"_\"?ite._\u00bbc\u2018|359\u00b0w - \nGlasgow &4 OSF . and Clyde i \nAppointments: 0141 211 4608\/5146 \nFax: 0141 211 4060 \n| ESP PHYSIOTHERAPY CLINIC \u2018 1 \n\u2018Clinic and dictated: 04\/04\/2013 \nTyped: 12\/04\/2013 \nOur Reference: Bb\/50D \nDr Mousumi Mukher jee \nBridgeton Health Centre \n201 Abercromby Street \nGlasgow \n&40 2DA \nDear Dr Mukherjee \nRe: Mr Henry Norwood 01\/01\/1950; CHI: 0101506015; CRN:20107395R \n248 Millroad Drive Glasgow Lonarkshire 640 2NS \nDiagnosis: Bilateral BDupuytren's disease mainly affecting right hand \nOutcome: To discuss with Mr Sianos with regards to surgery with such minimal flexion \n. contractures \nTt Ui iy - w e artiw\u2014, = d\u2014 \nThank you for referring this 63 year old right hand dominant gentleman to orthopaedic clinic. He has been \naware of bilateral Dupuytren's his hands for the past 2 years with deterioration of the right hand. Recently, \nhe has been aware of a \"burning sensation\u201d extending to his right ring finger which can be present even at \nrest. He is self employed involved in various areas of work but in particular as a designer and maker of \nfurniture. His biggest concern with regards to the function of his hand is ?hnt he cannot place his hand flat \non a piece of wood when sanding to test if it is smooth. . \nHis past medical history is that of early emphysema but he is on no medication. \nOn \u00e9xumina\ufb01on of his right hand he has fairly thick skin folds relating to the Dupuytren's producing only a \n10\u00b0 contracture of the MCP joint of the ring finger. The middle finger extends ta neutral only. On the right \nhand there is no evidence of joint contractures and just a minor puckering of the skin in line with his ring \nfinger. \nIt was explained to Mr Norwood that surgery at this early stage would not be indicated due to the minimal \ndegree of flexion contracture. He expliined that with his particular line of work this is a most distressing \ndysfunction. In view of this I will bring him to the hand clinic in 2 weeks where Mr Sianos will be in \nattendance to discuss whether fasciectomy surgery would be feasible. \nYours sincerely \n0o \nBRENDA DANKS \nExtended Scope Physiotherapy Practitioner 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