Dupuytren’s Contracture

Dupuytren’s contracture is a painful, and sometimes debilitating condition of the hands and feet. Fortunately, it is treatable and can be managed. Read on to find out more about the disease and the treatments available.

Symptoms

If you’re experiencing thickening of the skin on your palm or fingers, you may be suffering from Dupuytren’s contracture. This is a condition that is associated with ageing, and it affects men and women of different ages. However, the condition can be treated. Depending on your situation, you may choose to have surgery, corticosteroid injections, or a combination of treatments.

The most common symptoms of Dupuytren’s contracture are lumps, a hardened layer of tissue under the skin, and thick bands on the palm of the hand. These conditions can make it difficult to grasp objects and use your hands. In severe cases, the contractures can restrict the use of your thumb and make it harder to perform your daily activities.

In milder cases, a doctor can diagnose the condition through a simple examination. During this visit, he or she will look at your hands and ask about your family history. They will also examine your grip and feel for lumps and tough bands under the skin. You may be instructed to straighten and flatten your fingers, or to hold them at a slight angle.

For more serious conditions, your doctor may recommend a surgical procedure. Most people with Dupuytren’s contracture do not need surgery, but the condition can be difficult to treat. Some patients require repeated injections or have the cords return.

Corticosteroid injections can be used to treat pain and inflammation in people with Dupuytren’s. The injections can slow the progress of the condition, and some even find them effective in preventing the problem from worsening.

If your doctor finds that Dupuytren’s contracture is more advanced, he or she may recommend surgery. To do this, a needle is inserted into the affected area and stretched. Cords can also be cut and removed, but this requires a more extensive procedure.

Dupuytren’s contracture may be caused by other medical problems, such as diabetes or epilepsy. These diseases increase the chances of developing this condition. Fortunately, many people with Dupuytren’s develop the disease early on, without a serious contracture.

In some cases, the only symptoms of Dupuytren’s are nodules in the palm. These can be painful and are often removed carefully.

Diagnosis

Dupuytren’s contracture is an abnormal thickening of the tissue covering blood vessels, muscles, and nerves in the palm of the hand. Usually, it begins as a nodule and then progresses to a cord that binds the fingers together. The cord can be painful and may cause the fingers to become bent.

Dupuytren’s contracture can affect people of any ethnicity. People who smoke, have diabetes, or alcoholism are at a higher risk of developing the disease. Although not a curable condition, there are several treatments for it.

If you think you may have Dupuytren’s contracture, it’s important to get it checked out by a doctor. A physical examination can reveal the problem. Your physician will compare your hands and measure the range of motion in your fingers. He or she may also feel for hard knots or thick bands of tissue.

You may be asked to perform a test at home, such as the “tabletop” test. This involves holding your hand face down on a table. When your hand is flat on the table, your physician can see how many times the finger flexes. If it does not flex at all, your physician will be able to tell that your hand has Dupuytren’s contracture.

If your physician finds a cord, he or she can use a needle to break it. Needling is sometimes a treatment option for people who do not want to undergo surgery. It is a minimally invasive procedure that usually requires a local anaesthetic.

Another option is an injection, such as XIAFLEX(r). XIAFLEX(r) is an enzyme that breaks down the cord’s collagen. XIAFLEX(r) can be injected directly into the cord or into multiple cords. XIAFLEX(r) injections are used to improve the movement of the finger.

Vasectomy is another surgical option for people with Dupuytren’s contracture. A fasciectomy is a day surgery that involves cutting off the abnormal tissue from the fingers.

A supportive splint can help slow the progression of the disease. However, a splint will not keep the fingers from bending further.

Surgical options for Dupuytren’s contracture include needling, a fasciotomy, and a fasciectomy. These procedures can be done in a medical office.

Treatment options

Dupuytren’s contracture is a disease that causes thick cords to form under the skin of the palm of the hand. The cords are pulled toward the palm of the hand, making it difficult to straighten the fingers and grip small objects. Symptoms of Dupuytren’s contracture include lumps and tenderness in the palm.

Dupuytren’s contracture can be painful and debilitating. Fortunately, new nonsurgical treatments are available to slow or stop the progression of the disease. These treatments can be effective at improving the motion of the fingers and providing short-term relief from the discomfort associated with the condition.

Nonsurgical treatment can include collagenase injections. Collagenase is an enzyme that is extracted from bacteria. This treatment breaks up the cords of tissue in the Dupuytrens. It is used to treat patients with moderate to severe Dupuytren contracture.

Manual massage treatments can also help to reduce tension naturally. Chiropractors offer therapeutic massage techniques, such as instrument-assisted cross-frictional massage, which helps to release tension in the tissues.

Another alternative is corticosteroid injections. Corticosteroids can be used to stop the cords from forming and may ease the pain. However, the results are not always immediate.

If Dupuytren’s contracture persists, surgery may be necessary. Surgical options for Dupuytren’s contracture may include fasciotomy, subtotal palmar fasciectomy, and open fasciectomy. Depending on the extent of the disease, a patient may require postoperative rehabilitation to strengthen the hand and heal the area.

XIAFLEX(r) is an FDA-approved treatment for Dupuytren’s contracture. XIAFLEX(r) works by injecting medication directly into the cord of the Dupuytren’s tissue. XIAFLEX(r) helps prevent the nodules from growing and stopping them from contracting.

Surgery is usually recommended when a person has symptoms that cannot be treated by a nonsurgical option. In addition, the surgery usually restores the motion of the fingers. Some people experience complications, though, including skin grafting to repair damaged tissue.

The treatment that is right for you will depend on your health, the severity of your condition, and your goals. Having realistic expectations is important. Also, a thorough medical history will be taken and a physical examination will be performed. During your examination, your doctor will review your current medications and discuss the goal of your treatment.

Recurrence rate

The recurrence rate of Dupuytren’s disease is a common concern for hand surgeons. While the condition itself is benign, the recurrence of the disease can result in serious skin problems and joint contractures. Therefore, it is important to consider the long-term outcomes of treatment.

The recurrence of Dupuytren’s disease can be caused by various factors. Some of these include previous hand surgeries, previous trauma to the hand, diabetes, and alcohol intake. It can also be a result of a change in the aetiology of the condition.

Many researchers have attempted to study the causes of Dupuytren’s disease. These studies have led to the hypothesis that genetics may play a role. They have also identified occupational factors as possible causes. This includes exposure to hand-transmitted vibration and manual labour.

Although there are numerous environmental factors associated with Dupuytren’s disease, the exact aetiology has not been fully determined. However, research has shown that diabetes is one of the most significant risk factors.

The recurrence rate of Dupuytren’s contracture is not uniform across the world. Some reports indicate a recurrence rate of 2746.5%, while others say it is much higher. Nevertheless, it is possible to find several treatments for the disease, which can reduce its recurrence rates.

One of the most common treatments is a dermo fasciectomy. However, this procedure has a high recurrence rate. For this reason, some patients prefer to undergo a percutaneous needle fasciotomy instead. This is less invasive and results in a lower recurrence rate.

Another treatment is collagenase injection therapy. Injections of collagenase clostridium histolyticum have been shown to decrease the recurrence rate of Dupuytren’s. Collagen is a protein material that makes up 25-35% of total body protein. As a result, collagenase can break down the excessive buildup of collagen.

Several other methods have been proposed as treatments for Dupuytren’s. These include Xiaflex injections, which have a lower recurrence rate than fasciectomy. But, these injections are not suited for finger joint contractures.

Because the recurrence rate of Dupuytren’s is variable, the choice of treatment is ultimately left to the surgeon. Some surgeons have found that a non-surgical approach is the best way to treat the condition.
Dupuytren contracture – Symptoms and causes – Mayo Clinic
Dupuytren’s contracture – Wikipedia
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