Ron French, OT, CHT
Certified Hand Therapist
Disclaimer: This is for informational purposes only and should not replace medical treatment. Please seek treatment from a medical professional.
What is Dupuytren’s Contracture?
Dupuytren’s contracture is a disease that affects the fascia of the hand. Fascia is connective tissue made of collagen fibers that surround the muscles and organs providing structure and support. When the fascia thickens, it becomes more difficult to straighten your fingers and hard lumps or stiff bands may form on your palm. The symptoms progress slowly until you can’t flatten your hand, or your fingers begin to draw into the palm. Once your fingers pull in it can be difficult to reach into a pocket or shake hands. It most often affects the ring and small finger and is more common in descendants from northern Europe.
What are the treatments for Dupuytren’s Contracture?
Sometimes the fascia may thicken but not progress any further and no treatment is usually needed. If the symptoms worsen and the curling of the fingers interfere with your activities, you may need to seek professional care.
Conservative treatment is usually not effective to combat the symptoms of Dupuytren’s contracture. Avoiding tight grasping and wearing padded gloves with heavy activity may help alleviate some of the symptoms for a period. But finger splints or braces and stretching can make the symptoms worse.
There are several treatments available to combat Dupuytren’s contracture, here are two most common. An orthopaedic surgeon can help choose the right treatment for you and provide detailed benefits and complications. Hand therapy may be recommended following most orthopaedic care. Although surgery can relieve the symptoms, there is no cure for Dupuytren’s disease.
Needle Aponeurotomy This is becoming a popular treatment as it is less invasive than surgery. During the procedure the doctor uses a needle to break apart the thickened cords releasing the finger contracture. Pros: Relatively simple procedure, serious complications are rare, less expensive than surgery or collagen injections, can be repeated if contracture returns. Cons: May not be appropriate for all forms of Dupuytren’s, recurrence is more common when compared to surgical treatment.
Palmar Fasciectomy Surgery This is a common surgery used to treat even the worst Dupuytren’s contracture. Your doctor can help you decide when surgery is right for you. During the surgery an incision is made across the palm and the diseased tissue is removed. After surgery your doctor will give you instructions to combat swelling and pain. Once stitches are removed, you will be ready to start hand therapy to combat scar tissue that can build up following surgery limiting your motion. Hand therapy will also address any other issues like pain and numbness.
Pros: Most effective, may take years or more for symptoms to return. Cons: Cost, scar tissue, numbness, general precautions with surgery.