Procedures
If you need surgery for Dupuytren's contracture you'll get a fasciotomy. For this procedure, your surgeon removes tissue from your palm through a surgical cut. Then the open wound is allowed to heal on its own, or it is covered with a skin graft taken from another part of your body.
Therapy
Key points about Dupuytren's contracture Dupuytren's contracture is an abnormal thickening of the skin in the palm of the hand. The skin may develop into a hard lump. ... You may not be able to use your hand for certain things. In many cases, both hands are affected. There is no cure, but treatment can improve symptoms.
Self-care
What Dupuytren treatment do I recommend?
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What happens when you get surgery for Dupuytren's contracture?
Prevention / remedies / cures / treatment for Dupuytren's contracture
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What you should know about Dupuytren's contracture?
What is Dupuytren treatment do I recommend?
What are some remedies for Dupuytren's disease?
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What is the latest treatment for Dupuytren's contracture?
Xiaflex was released last year by the FDA for non-surgically treating Dupuytren's contracture. This new injection, based in an enzyme, breaks down the diseased tissue allowing the finger to be easily manipulated into a straighter position. The first day the medicine is injected into the diseased 'cord' of tissue.
How do you slow down Dupuytren's contracture?
Doctors may use steroid injections to ease pain or radiotherapy to help slow the progression of the disease. Enzyme injections with collagenase clostridium histolyticum or a needle aponeurotomy can help loosen the fibrous tissue in cases of moderate to severe Dupuytren's contracture.
How do you fix Dupuytren's contracture without surgery?
XIAFLEX® is the only FDA-approved treatment for Dupuytren's contracture that does not require surgery. A hand specialist will inject this enzyme treatment directly into the cord that's causing limited mobility in the finger.
When should Dupuytren's contracture be treated?
If you develop a severe contracture of more than 20 to 25 degrees, it's time to consider an intervention, he says. Doctors usually recommend starting with minimally invasive nonsurgical treatment and then moving to surgical options if necessary, according to the Dupuytren Research Group.
Can Dupuytren's go away?
Unfortunately, there is no cure for Dupuytren's Contracture, but there are some treatments a hand specialist can recommend and perform to break apart the cords of tissue that have formed, which pull the finger to a bent position.
Is Dupuytren's a form of arthritis?
Dupuytren's contracture: This form of arthritis causes the tissue beneath the hand to develop nodules in the fingers and palms. These lumps can cause the fingers to stick in place.
What happens if you don't treat Dupuytren's contracture?
But a more likely scenario if you don't treat Dupuytren's is that over time your hand will develop hard chord-like formations that pull on your ring or pinky fingers, pulling them into a stuck position. If this goes untreated, it can make simple tasks involving your hand very difficult.
Does stretching make Dupuytren's worse?
If your fingers are too stiff or curled to do this exercise, do not try to forcefully extend or stretch them. This could make your contracture worse. Dupuytren's contracture most commonly affects the ring and pinky fingers, but all your fingers could be involved.
Is there a pill for Dupuytren's contracture?
XIAFLEX is a prescription medicine used to treat adults with Dupuytren's contracture when a “cord” can be felt.
How serious is Dupuytren's contracture?
The condition is not dangerous. Many people don't get treatment. But treatment for Dupuytren's contracture can slow the disease or help ease your symptoms.
How do you get Dupuytren's disease?
Dupuytren's contracture often runs in families. Tobacco and alcohol use. Smoking is associated with an increased risk of Dupuytren's contracture, perhaps because of microscopic changes within blood vessels caused by smoking. Alcohol intake also is associated with Dupuytren's.
What should I avoid with Dupuytren's contracture?
If you have mild Dupuytren's contracture, you can protect your hands by: Avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape. Using gloves with heavy padding during heavy grasping tasks.
How to tell if Dupuytren's contracture is gone?
What are the symptoms of Dupuytren's contracture? Common symptoms may include: Not being able to lay your hand flat on a table, palm down (called the tabletop test) One or more small, tender lumps (nodules) in the palm. Over time, the tenderness usually goes away. The nodules may thicken and contract or tighten.
Why does Dupuytren's contracture run in families?
The exact cause is not known. It may be linked to cigarette smoking, alcoholism, diabetes, nutritional deficiencies, or medicines used to treat seizures.
What is the procedure to straighten the fingers?
This lets the fingers straighten when the cord is snapped by the surgeon, usually the next day. Needle aponeurotomy. This is another newer, less invasive procedure. Medicine is injected into the area to numb the hand. The surgeon uses a needle to divide the diseased tissue. No incision is made.
What is the most common treatment for advanced cases?
This is the most common treatment used for advanced cases. It may be done when you have limited use of your hand. During Dupuytren's contracture surgery, the surgeon makes a cut (incision) in your hand and takes out the thickened tissue. This can improve the mobility of your fingers.
Is Dupuytren's contracture dangerous?
There is no cure for Dupuytren’s contracture. The condition is not dangerous. Many people don’t get treatment. But treatment for Dupuytren's contracture can slow the disease or help ease your symptoms. Treatments for Dupuytren's contracture may include: Surgery.
Is there a cure for Dupuytren's contracture?
How well you handle certain medicines, treatments, or therapies. If your condition is expected to get worse. What you would like to do. There is no cure for Dupuytren’s contracture.
Is Dupuytren's contracture more common in men than women?
You may be at greater risk for Dupuytren’s contracture if you: Are older. The condition usually starts in middle age. Are male. It is more common in men than women. Have a Scandinavian or Northern European background. It is most common in people whose families come from these regions.
What is the problem with Dupuytren's contracture?
As mentioned earlier, one of the major problems with the treatment of Dupuytren's contracture is that the underlying problem is unchanged. Dupuytren's disease is the condition that causes the collagen in your body to be poorly regulated.
How to treat Dupuytren's disease?
Stretching and Injections . There used to be a time when physicians recommended stretching, splinting, and injecting cortisone into Dupuytren's tissue. In general, these treatments are, at best, only temporarily helpful and, at worst, they can actually make the condition progress more quickly.
What is collagenase injection?
Collagenase is an enzyme that is extracted from a bacteria. This enzyme is injected directly into a cord of Dupuytren's tissue and then allowed to break down the tight, contracted tissue. People who receive these injections will usually return to their doctor's office the following day after the enzyme has had an opportunity to break down the tight tissue. At that point, your physician will manipulate the finger forcefully to fully break the contracted tissue.
What is needle aponeurotomy?
Needle aponeurotomy is a minimally invasive procedure that instead of removing the contracted Dupuytren's tissue, it uses the point of a needle to sever the cords and relieve contractures. Your doctor makes small punctures in the skin, no incisions, and by manipulating the tip of the needle, cuts through the contracted tissue in several locations.
Why do we wait on Dupuytren's?
The traditional "treatment" recommendation for people with this condition was to wait on Dupuytren's contracture as long as tolerable and only then have surgical treatment. This is what doctors call "watchful waiting.". The reason to wait on surgical treatment was that Dupuytren's was never cured and repeat treatment was likely to be necessary ...
Why do we wait for surgical treatment?
The reason to wait on surgical treatment was that Dupuytren's was never cured and repeat treatment was likely to be necessary at a later point. And, by waiting to treat the condition, the number of treatments needed throughout a patient's lifetime was kept to a minimum. 1 .
Does Dupuytren's disease cure?
In addition, while all of these procedures address the contracted tissue of Dupuytren's, none of them cure the underlying condition called Dupuytren's disease. Therefore, recurrence of the contracture is always a possibility, no matter what treatment is performed.
Overview
Dupuytren's contracture is a painless deformity of the hand in which one or more fingers (in this case, the two fingers farthest from the thumb) are bent toward the palm and can't be fully straightened. It results from a thickening and scarring of connective tissue under the skin in the palm of the hand and in the fingers.
Symptoms
Dupuytren's contracture typically progresses slowly, over years. The condition usually begins as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled. A firm lump of tissue can form on your palm. This lump might be sensitive to the touch but usually isn't painful.
Causes
Doctors don't know what causes Dupuytren's contracture. There's no evidence that hand injuries or occupations that involve vibrations to the hands cause the condition.
Risk factors
A number of factors are believed to increase your risk of the disease, including:
Complications
Dupuytren's contracture can make it difficult to perform certain functions using your hand. Since the thumb and index finger aren't usually affected, many people don't have much inconvenience or disability with fine motor activities such as writing.
What are some nonsurgical treatments for Dupuytren's?
Nonsurgical treatments are often recommended at early stages of Dupuytren's or in addition to surgery. While many nonsurgical treatments have been studied, only a small number have shown a benefit. Stretching. Experts may recommend stretching for the mildest forms of Dupuytren’s.
What are the side effects of Dupuytren's contractures?
Another option for treatment is low energy radiation therapy. It may help symptoms and prevent worsening of the the cords, nodules, and skin changes that can come with Dupuytren's contractures.
How to treat Dupuytren's disease?
Steroid injections may reduce the size of nodules early in the course of disease but are less effective in the later stages of Dupuytren’s when more thickened tissue has formed. Steroid injections may help slow progression of the condition but won't help straighten your finger if you already have a contracture. Enzyme Injections.
What to do if your finger is bent?
If your finger is already bent, your doctor may recommend Xiaflex, a mixture of enzymes that is injected into the affected area to break up the tough tissue. The drug loosens the tissue. If the contracture is still present on the following day, your doctor will stretch your finger and try to straighten it.
Can you get physical therapy after Dupuytren surgery?
Many do not need rehabilitation with physical therapy following the procedure. A presurgical evaluation can determine whether you are a candidate for this procedure. Surgery may be able to correct the changes of Dupuytren’s. It can often take care of the contraction and restore function to the hand..
Can stretching help with Dupuytren's nodule?
Steroid Injections. These strong anti-inflammatory medications, when injected into a Dupuytren’s nodule, may be helpful. Often, however, multiple injections are necessary.
Can Dupuytren's be worse?
In some people, the condition may progress slowly and it may never become worse than a bit of lumpiness in the palm of your hand. A simple wait and see approach may be all that is necessary if your Dupuytren’s is mild and does not affect your daily life.
What is the best treatment for Dupuytren's contracture?
For many years, surgical fasciectomy was the standard treatment for Dupuytren’s contracture and remains a reliable option for advanced and severe cases. Fasciectomy is a surgery that removes layers of the fascia, which is the tissue in the hand that becomes hard and chord-like from having Dupuytren’s contracture.
What is the treatment for Dupuytren's?
Dupuytren’s Treatment: CCH Collagenase Injection. A common alternative to surgery (more on this below) for Dupuytren’s is an injectable form of collagenase clostridium histolyticum (CCH), which is an enzyme extracted from bacteria. These enzymes break down the collagen buildup in the hand that causes lumps and chords in Dupuytren’s.
Is Dupuytren's contracture dangerous?
Dupuytren’s contracture is a hand deformity that develops over a span of several years and is not dangerous, although it can be rather awkward or inconvenient, and it can return after treatment. When you have Dupuytren’s, too much collagen builds up in the hand and your body is not able to properly break it down.
Is Dupuytren's a cure?
None of the currently available options addresses the underlying cause of Dupuytren ’s, which comes from the body’s overproduction of collagen and inability to break down old collagen properly; therefore, treatments are not a cure. However, many people who undergo treatment do not have recurring symptoms.
Can Dupuytren's cause a bad job?
Dupuytren’s can have a severely negative impact on work, use of cellphones, driving, exercise, cooking, cleaning, and much more. If you suspect you could have Dupuytren’s contracture, it’s important to see a doctor so you can get a proper diagnosis and discuss your treatment options. The goal of Dupuytren’s treatment is to break up or dissolve ...
Is CCH surgery the only treatment for Dupuytren's?
Although CCH Injections and surgery are widely regarded as the two most effective Dupuytren’s treatment options, they are not the only options. Here are others you might discuss with your doctor:
What is contracture in hand?
To put things in a more descriptive manner, the term “contracture” is a nasty process that affects your hand whereby the skin and tissue form a layer of knots under the palm. This can take years to build up and eventually leads to a thick cord being formed that causes a finger or two to be bent uncomfortably.
What is the process of putting enzymes in the palm of the hand?
Enzyme injections. This process is done with a certain type of enzyme being injected into the taut cord of the palm to ease and incapacitate it, so that it can later be operated on by a doctor. The doctor would later be able to easily align the fingers.
What is the best tool to stretch your finger?
There are several options on the market for tools offering ultrasound, heat and stretching. The most commonly used device is the Dupuytren’s Wand. The stretch is typically controlled by an elastic tape “splint” offering a strong recoiling effect to encourage the finger to remain in a straightened position.
Is there a cure for Dupuytren's contracture?
There is no cure, so taking preventative measures and trying to comfort the knots in the hand is the best solution. There are a few options for non-surgical treatments for Dupuytren’s Contracture but a extremely invasive surgery is commonplace for sufferes .
Does surgery guarantee non-reoccurrence?
It has a more conclusive and lasting effect compared to the other methods. In addition, surgery does not guarantee non-reoccurrence.
Is Dupuytren's contracture more likely to affect men or women?
It is more likely to affect men rather than women. Dupuytren’s contracture is more likely to affect people with ages 50 and above. Genetics and family history play a large factor. It has been researched that people who smoke and drink are more likely to contract the disease.
Drugs used to treat Dupuytren's contracture
The following list of medications are in some way related to, or used in the treatment of this condition.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
What is the treatment for Dupuytren's disease?
Needle aponeurotomy, also called needling or percutaneous needle fasciotomy, is another minimally invasive treatment option for Dupuytren’s disease. This treatment option, which can be performed in your doctor’s office, involves placing a needle in the tough tissue that is causing the contracture of your fingers.
How many people have Dupuytren's contracture?
Approximately 15 million Americans have Dupuytren’s contracture. The symptoms of Dupuytren’s contracture vary depending on the progression of the disease. In the early stages, you may notice the skin of your palm thickening. As it progresses, the Dupuytren’s disease condition will change noticeably.
How to treat palm pain?
Reduce Palm Pressure. The skin on the palm of the hand is where this disease starts. You can help manage your symptoms by protecting the affected hand or hands: Practice a looser grip: When we grip something like a tool or a cup of water, the palm usually curls around the object.
How to stop Dupuytren's disease?
2. Try Exercises . Stretching does help Dupuytren’s contracture, and there a number of exercises you can do to help manage this condition. Exercises and stretches will not necessarily stop or slow the progression of the contracture, but they are helpful options during the early stages of Dupuytren’s disease:
What age group is most likely to develop Dupuytren's disease?
The following groups of people may be at risk for developing Dupuytren’s disease: People over the age of 50: Dupuytren’s disease is more likely to develop in older adults. People with family history: Genetics play a role in the likelihood of developing Dupuytren’s contracture.
Can a cord of tissue in the palm cause a finger to curl?
Eventually, that tissue will begin to form cords that reach up through the palm to the fingers. As these cords tighten, they may cause the fingers to contract. In the later stages of the disease, the contraction of the fingers can become extreme, curling the affected fingers very close to the palm.
Can you get Dupuytren's disease with a steroid injection?
While Dupuytren’s disease is typically characterized as painless, some people may feel pain in the nodes of tissue that form in the palm. In this case, you may be a candidate for a steroid injection. Steroids can reduce inflammation and pain. You may need to have a series of injections to manage your symptoms.
