Dupuytren’s Contracture

What is Dupuytren’s Contracture?

Dupuytren’s contracture is a condition in which the fingers of the hand bend in towards the palm. It is caused by a thickening of the tough connective tissues in the hand (called fascia) which can lead to the fingers being drawn into the palm.

What causes Dupuytren’s Contracture?

Dupuytren-like thickening of the fascia can be the result of laceration or trauma, but Dupuytren’s itself is the result of genetic predisposition. Between 60 and 70% of all people who suffer from this problem have one or more genetic relatives who have also suffered from it.

What are symptoms of Dupuytren’s contracture?

Dupuytren’s contracture most often presents in its earliest stages as a simple thickening of the fascia of the palm, which causes the palm to feel tough and bumpy. At first, the bumps will be painful, but over time the pain will go away, although the condition will continue to progress. Over time, it will slowly grow to the point that all of the fingers are curled into the palm, rendering the hand almost useless. The little and ring fingers are most commonly affected, and the middle finger can be included in some severe cases, but the index finger and thumb are seldom afflicted.

How to diagnose Dupuytren’s contracture

Dupuytren’s can sometimes be confused with trigger finger in its early stages, but once the thickening of the fascia is detected, a diagnosis is more readily reached. Once the fascia have begun to noticeably thicken, Dupuytren’s is apparent, and the doctor will proceed to treat accordingly.

Non-surgical treatment of Dupuytren’s contracture.

More often than not, surgery is unnecessary, but even with it, there is no permanent way to cure or arrest the condition. There have, however, been some successes with the use of Xiaflex, an injectible medication (link to Xiaflex information article on home page). Xiaflex acts by selectively dissolving and softening the thickened tissues, allowing greater freedom of movement in the hand and fingers. It offers a promising non-surgical treatment to ease the contracture, but can be used only in select cases.

Surgical treatment of Dupuytren’s contracture.

Surgical treatment is traditionally the preferred method of dealing with the problem, and it consists of incisions in the skin that opens up the palm so that the fibrous tissue can be thinned out or removed entirely where possible. The fascia can grow into the skin, or dermis, so that must also be taken into account and dealt with by the physician. While the surgery seems invasive, it leaves minimal scarring and causes surprisingly little discomfort or pain.

How can Dr. Knight help you with Dupuytren’s Contracture?

Dr. Knight will, upon diagnosing Dupuytren’s, decide which route will be the best to take and discuss his conclusions with you. While he prefers a conservative, non-surgical remedy, he is comfortable making whichever decision may be necessary to best relieve your pain and discomfort.

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