Tropical Diabetic Hand Syndrome: report of 2 cases

Abstract

Diabetes mellitus is a metabolic disorder in which there is hyperglycaemia as a result of quantitative and/or qualitative deficiency of insulin. The resulting derangement in glucose metabolism has far reaching consequences on various organ systems in the body. Though primarily a medical condition, some of the complications of diabetes mellitus affecting the limbs may warrant the involvement of the Orthopaedic Surgeon in the management of the patients. The most commonly described lesion affecting the extremity is the diabetic foot syndrome whose manifestation ranges from cellulitis, ulceration to gangrene. However, of recent similar lesions affecting the foot in diabetics are being seen in the hand of these patients. The first of these hand lesions was described in the United States in 1977 [1] and in Nigeria in 1984 [2]. Its incidence seems to be on the rise especially in Africa and India where it is now being referred to as Tropical Diabetic Hand Syndrome (TDHS). Even though this condition in Africa was first described in Nigeria over twenty six years ago [1], not many of such cases have been seen or reported since then. We report two recent cases seen in our centre to draw attention of medical practitioners to this condition that is threatening the function and survival of the hand in diabetic patients in our country.

Keywords

• tropical
• diabetic
• hand
• syndrome