132019Aug

What is Dupuytren’s Contracture?




An orthopedic condition affecting the fingers and hand, Dupuytren’s contracture progresses so slowly that many people are unaware they have it until its later stages. In the condition’s advanced stages, patients may have extremely bent fingers, and they’ll likely experience difficulty doing everyday activities such as shaking hands, putting on gloves, and handling large objects.

In its earliest phase, Dupuytren’s contracture shows up as lumps of tissue under the skin of the palm of the hand. Patients may also notice a dimpling of the skin. According to the Dupuytren Research Group, about 15 million Americans aged 35 or over have the disorder if those experiencing early signs are counted.

As the condition progresses, the tissue continues to thicken, eventually forming tight cords that pull the pinky and ring finger down toward the palm. The condition can affect both hands, although one hand may exhibit more severe signs of the contracture than the other.

A direct cause has yet to be identified, although patients display a number of common risk factors. Dupuytren’s contracture is most often diagnosed in people over age 50 who trace their ancestry to Northern Europe. It strikes men more than women, and it tends to run in families. Cigarette smoking and diabetes increase the chance of developing the disorder, as well.

In mild Dupuytren’s contracture cases, patients experience no pain and are able to carry on with their normal activities. For many, the disorder never progresses to the point where their fingers contract abnormally. When the condition advances to a pronounced bending of the fingers, then treatment may be required.

Dupuytren’s Contracture Treatment Options

A physical examination of the hand determines the onset of Dupuytren’s contracture. A doctor may also test the feeling and range of motion in the fingers. Depending upon the severity, one of the following non-surgical or surgical therapies may be recommended. Since there is no cure for Dupuytren’s contracture and it can recur, these treatments are geared towards helping patients regain the use of their hand. 

Needling. In this procedure, a doctor uses a needle to penetrate the thickened cord, loosening the tissue so that the fingers no longer bend. This procedure is performed on an outpatient basis, and patients are simply given a local anesthetic to numb the hand.

Enzyme Injection. Similar to needling, a doctor injects a FDA-approved substance into the cord to weaken it. The doctor will then manipulate the hand to break apart the cord.

Surgery. There are two types of surgery to treat Dupuytren’s contracture. The first option, a less intensive operation, entails a surgeon separating the cord to relax the contracture and allow movement of the fingers. After this surgery, patients wear a splint. 

The more intensive option involves removal of most of the thickened cord. Because so much tissue is removed, the patient may need a skin graft to cover the incision. Recovery time is longer, and patients undergo physical therapy to restore hand function.

These treatments are not a cure, and there is a chance the contracture will return even after surgery. Potential complications from surgery include infection, stiffness, and nerve damage.

Are Your Fingers Bent?

Here at Florida Hand Center, we treat a variety of orthopedic hand disorders, including Dupuytren’s contracture. Let’s us review your condition and recommend therapy options that will heal your hand. Make an appointment and speak to one of our specialists today.