Dupuytren’s contracture is not painful, but it is frustrating and debilitating. It usually affects the small fingers on the hand: the pinky and occasionally also the ring finger.
This condition usually occurs in just one hand, but it can affect both hands. It is simple to diagnose, marked by the complete inability to straighten the affected fingers – even with assistance or by pulling – and the presence of toughened knots or bands of tissue in the palm that are hard to the touch.
It begins with a lump in the palm, and one or more fingers begin to curl inward. Eventually, those fingers will close completely if no treatment is sought. The good news is that having treatment sooner rather than later usually produces more effective results; but the further along the condition has progressed, the more difficult it is to reverse.
Diagnosing Dupuytren’s Disease
Verifying this condition is quite simple: Place the hand flat on a table. The inability to flatten the fingers against the table usually indicates the presence of Dupuytren’s contracture.
The disease progresses very slowly over a period of years. As long as the person can use their fingers, it doesn’t require treatment – the physician will likely recommend a wait-and-see approach to determine whether further contracture progresses.
Treatment for Dupuytren’s Contracture
If the condition has gotten to the point that flattening the affected fingers against a tabletop or other flat surface is impossible, then it is time to seek treatment. This involves a physician either removing the bands of tissue or breaking the cords up in some way.
The treatment used depends on the progression of the disease. It can range from needling to enzyme injections to surgery:
In this treatment, a large-gauge needle is inserted into the bands of tissue that are causing the contraction. Needling helps to break them up so that the doctor can then straighten out the affected fingers.
This is often accompanied by a small tearing of skin that has grown taut with the bands. One disadvantage is that this treatment may need to be repeated later.
The doctor must be careful when performing this treatment so as not to harm nearby nerves or tendons. (Which is also why you cannot perform this treatment safely on yourself.)
Using a certain type of enzyme, usually Xiaflex (a Clostridium histolyticum collagenase), your doctor will inject this substance into the problematic cords. The goal is to soften the cords enough for the doctor to be able to manipulate the fingers until they are straight.
The results are similar to needling, and they may be used in combination to achieve the best results. This may be required again later if the contracture begins to come back.
For people who have very limited mobility and advanced-stage Dupuytren’s contracture, surgery can be performed to completely remove the tissue in the palm that is affected by the disease. This offers the best chance at permanently thwarting the disease’s effects.
Following this mode of treatment, physical hand therapy is normally required for several months. This will help to restore full functionality in the hand and fingers.
Hand Doctor in Maryland
If you have one or more fingers that are curling closed, and you notice when washing your face that the fingers poke you in the eye, chances are you have Dupuytren’s contracture. Seeking treatment will help to prevent the condition from becoming worse.