Dupuytren's Contracture
Dupuytren’s contracture affects the hands. It is characterized by the thickening and tightening of the fibrous tissue under the skin of the palms and fingers, called the fascia. This tissue becomes stiff and can pull the fingers inward, creating a “claw-like” look and limiting the ability to fully extend the affected digits. The condition is named after the 19th-century French surgeon Guillaume Dupuytren.
Dupuytren’s contracture may seem rare, but it is more common than you think. It affects about 1 in 20 individuals in the United States. This hand disorder can significantly impact daily life, making even the most mundane tasks challenging, such as grasping objects or buttoning shirts.
Causes of Dupuytren’s Contracture
The exact cause of Dupuytren’s contracture is unknown, but several factors have been identified that may contribute to its development. Genetics plays a crucial role, as the condition is more common in individuals with a family history of the disorder. Certain medical conditions, such as diabetes and epilepsy, have been linked to an increased risk of developing Dupuytren’s contracture.
Gender is also a factor, with men being more frequently affected than women. The condition typically manifests later in life, often after age 50, although it can occur at any age. Trauma to the hand, including surgery, has also been known to trigger or exacerbate the progression of Dupuytren’s contracture in some individuals.
Symptoms of Dupuytren’s Hand Contracture
The initial signs of Dupuytren’s hand contracture are often subtle. Small, firm lumps or nodules on the palms of the hands may be tender or painless. These nodules gradually develop into thick, cord-like structures that pull the fingers inward.
As the condition progresses, the affected fingers may become increasingly difficult to straighten, known as “Dupuytren’s contracture.” The ring and little fingers are the most affected, but the condition can also impact the middle and index fingers and the thumb. The progression of this condition can vary significantly from person to person.
Diagnosing Dupuytren’s Contracture
Diagnosing Dupuytren’s contracture involves a thorough physical examination by your physician. During the examination, the physician will assess the presence of nodules, cords, and the degree of finger contracture. In some cases, imaging tests, such as X-rays or ultrasounds, may be ordered to rule out other potential causes of hand deformities.
You can test at home using the “tabletop test.” This involves placing your palm flat on a table and observing whether the fingers can lie flat. If they cannot, it may indicate Dupuytren’s contracture.
Outlook and Prognosis
Dupuytren’s contracture is not curable and can significantly impact quality of life, making even the most basic tasks challenging. The good news is that the condition is highly treatable. Many patients can regain a significant degree of hand function and mobility with the right combination of nonsurgical and surgical interventions.
Nonsurgical Treatment Options for Hand Contracture
Several nonsurgical treatment options are available for those with mild to moderate Dupuytren’s contracture. These approaches aim to slow the progression of the condition and improve the range of motion in the affected fingers but cannot prevent the condition from worsening over time.
Steroid Injections
Injecting corticosteroids directly into the affected nodules can help reduce their size and discomfort, providing temporary relief.
Collagenase Injections
Another innovative nonsurgical approach is the use of collagenase injections. Collagenase is an enzyme that can break down the thickened cords of tissue associated with Dupuytren’s contracture. After the injection, your physician will gently manipulate the affected finger to help rupture the cord, allowing for an improved range of motion.
Surgical Treatment Options for Dupuytren’s Contracture
For many patients with more severe or advanced Dupuytren’s hand contracture, surgical intervention may be recommended. These surgical procedures aim to remove or disrupt the thickened cords of tissue, allowing for improved finger mobility.
Fasciotomy
In a fasciotomy, a physician makes an incision in the palm to divide the thickened cords of tissue. This can help to release the tension and improve the ability to straighten the affected finger.
Partial Palmar Fasciectomy
A more extensive surgical approach is the partial palmar fasciectomy. In this procedure, a physician removes as much of the abnormal tissue and cords as possible, helping to straighten the affected finger.
Rehabilitation & Recovery
Rehabilitation and recovery are crucial after treatment for Dupuytren’s contracture. They help you regain full use of your hand and reduce the chances of the problem returning. The rehabilitation plan depends on the severity of your condition and the treatment you received.
- Physical Therapy: Your doctor may recommend physical therapy to help improve the flexibility and strength of your hand.
- Splinting: Wearing a splint after treatment helps keep your fingers in the correct position, supporting healing and preventing hand contracture from returning.
- Wound Care: If you had surgery, properly caring for the wound is essential to prevent infections and help it heal well.
- Managing Pain: After treatment, your physician may prescribe pain medications or suggest other ways to help you feel more comfortable.
Preventing Dupuytren’s Contracture
There is no known way to prevent the development of Dupuytren’s hand contracture. Some steps may slow the condition’s progression or reduce the risk of recurrence after treatment.
Maintaining a healthy lifestyle, including regular exercise and a balanced diet, may help manage the condition. Avoiding activities or behaviors that may contribute to the development or worsening of Dupuytren’s contracture, such as excessive alcohol consumption or hand injuries, can also be beneficial.
Take Control of Dupuytren’s Contracture
At Florida Medical Clinic Orlando Health, our specialized team is equipped with the latest knowledge and advanced treatment options to help you manage Dupuytren’s contracture effectively. If you or a loved one is experiencing symptoms, don’t hesitate to schedule an appointment with our team for treatment. Contact us today to learn more about how we can assist you in achieving better hand health and improving your overall quality of life. Your path to improved hand function starts here.