Dupuytren’s Contracture

Dupuytren’s Contracture is a thickening of the deep tissue that passes from the palm into the fingers, and can cause the fingers to be flexed towards the palm as the disease progresses. It frequently affects the ring and little fingers, but may affect any fingers (or thumbs) of either hand. Symptoms usually start as a small nodule or pit in the palm of the hand, which can then develop into cords of tissue that pull the fingers back towards the palm (the Contracture). Not all patients will develop contractures and may be monitored only.

Why would I get Dupuytren’s Contracture?
There is no known cause for the contracture, although it can run in families. It may also be noticed after trauma to the hand (including surgery), in some diabetics, epileptics or in some individuals with liver disease. There is no truth, however, that the condition is related to alcoholic intake.

What can be done about Dupuytren’s Contracture?
A considerable amount of research is taking place to create a drug treatment for the condition but at present none is available. As a result, surgery is the only available treatment once the condition becomes significant. Untreated, Dupuytren’s Contracture can result in affected fingers being pulled into the palm with significant loss in hand function. More recently an enzyme has been developed , Collagenase (xiapex) which can be injected on day 1 and the cord snapped under a local anaesthetic 24-48 hours later. This treatment is suitable for certain disease patterns only.

There are some common operations to treat this condition such as needle fasciotomy, fasciectomy, dermofasciectomy. These procedures are discussed at length with your surgeon who will decide the best course of action. 

How long will it take to recover?
Recovery times are dependent on the severity of the condition, but a splint may be needed for many months after the operation to maintain the surgical correction of the finger(s). At first, it will be necessary to wear the splint night and day, but often this reduces to night-time only after about a fortnight (when your stitches are removed).

 

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