Hand Joint Conditions

Dupuytren’s Contracture

What is Dupuytren’s contracture?

Dupuytren’s contracture is a hand deformity that usually develops over years.
The condition affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin — eventually creating a thick cord that can pull one or more fingers into a bent position.
The affected fingers can’t be straightened completely, which can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands.
Dupuytren’s disease mainly affects the ring finger and little finger, and occurs most often in older men of Northern European descent.

What Causes Dupuytren’s Contracture?

Dupuytren’s contracture causes include some of the following:

  • Alcoholism
  • Anti-seizure medications
  • Diabetes Mellitis
  • Eastern European/ Viking background
  • Family history
  • HIV
  • Having similar contracture in the feet (Ledderhose’s disease)
  • Working with vibration equipment long-term

What is the initial clinical sign of Dupuytren’s contracture symptoms?

  • Initially, lumps will form in palm of hand known as “nodules”. After time, small nodules join up to form a longer “chord”.At this point there may be no symptoms other than stiffness in the fingers and a bumpy appearance of the palm or the finger.
    After time, the chords start to contract causing the fingers to bend with a clenched pinkie or ring finger, which cannot be straightened out. You’ll experience difficulty picking up large objects or putting your hands in your pocket, as well as shaking hands or wearing gloves.
    Dupuytren’s contracture can sometimes be confused with symptoms for trigger finger.

How is Dupuytren’s contracture diagnosed?

A diagnosis for Dupuytren’s contracture requires a clinical examination. Your doctor will need to examine your hands in order to make the diagnosis. Generally, there are no x-rays required, and an ultrasound is rarely used.

Dupuytren’s contracture treatment

Treatments are generally measured on the level of discomfort that a patient has. If the pain is impacting severely on the quality of life then Xiaflex Injections are recommended.
Once Dupuytren’s contracture has reached a point where it affects activities of daily living (such as, the bent finger getting stuck in clothing), surgery can be considered. by a hand specialist.
Dupuytren’s contracture surgery involves removing the diseased cords and nodules under the skin and mobilizing the fingers as soon as possible. Typically, Dupuytren’s contracture has a high rate of recurrence and it is not uncommon for patients to need the same procedure in a few years.

Dupuytren’s contracture surgery recovery time

A few points on surgery recovery for Dupuytren’s Contracture:

  • After surgery, one hospital night stay is recommended.
  • Surgical wounds take longer to heal especially if Dupuytren’s disease was severe. Anywhere between 2-6 weeks
  • You won’t be able to wet your hand for 3-4 weeks after surgery
  • Your fingers will be sore, swollen and stiff to start with post-surgery, with functioning returns with the help of hand therapy and Dupuytren’s contracture exercises, only after 2-3 months
  • Severe cases will need a night time splint to be worn up to 6 months after surgery. You’ll be able to use your hand for most day to day activity by 3 months unless the disease is severe
Matthan Mammen

Matthan Mammen

MS, FRACS (Orth)

Matthan is an internationally qualified orthopaedic surgeon, who is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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