10 Facts and Tips for Dupuytren s Contracture Dupuytren s Contracture Everyday Health
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10 Facts and Tips for Dupuytren s Contracture Dupuytren s Contracture Everyday Health
10 Facts and Tips for Dupuytren’s Contracture – Dupuytren’s Contracture – Everyday Health MenuNewslettersSearch Dupuytren’s Contracture 10 Facts and Tips for Dupuytren’ s ContractureDupuytren’s contracture is hand deformity that can cause fingers to curl inward
Get helpful facts and tips you should know about Dupuytren’s
ByChris Iliades, MDMedically Reviewed by Niya Jones, MD, MPHReviewed: July 9, 2013Medically ReviewedNamed after the French surgeon who first described it in 1834, Dupuytren’s (pronounced DOO-pa-trens) contracture is a progressive hand condition that causes thickening of the palmar fascia, the tissue under the palm
As this tissue thickens and contracts, your fingers may start curling into the palm of your hand
“Dupuytren’s contracture may cause painful nodules in the palm of the hand or painless thick bands that may eventually make it impossible to extend the fingers,” says Peter J
Evans, MD, PhD, an orthopedic surgeon and director of the Upper Extremity Center at the Cleveland Clinic in Ohio
Although Dupuytren’s contracture tends to progress slowly over years, you shouldn’t ignore its signs and symptoms
Find out more about the condition
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…Learn More FACT Dupuytren’ s Contracture Is HereditaryDupuytren’s contracture can be passed down through families and is most common in people who have ancestors from Scandinavia and other areas in northern Europe
According to the British Dupuytren’s Society, this hand deformity can affect up to 20 percent of men older than 60 and 20 percent of women older than 80 in the United Kingdom
A 2011 Internet survey to see how many Americans have Dupuytren’s found that just 1 percent of responders had been diagnosed with the disorder, and 7 percent had symptoms of Dupuytren’s contracture but had never been diagnosed
Of those diagnosed, 18 percent reported a close family member who had symptoms of Dupuytren’s
TIP Know The Risk FactorsFamily history isn’t the only risk factor for Dupuytren’s
Others include having diabetes, being male, being older, smoking, drinking alcohol, and taking certain medications for seizures, most commonly phenobarbital
You’re also at higher risk for Dupuytren’s contracture if you’ve experienced contracture in other parts of your body, such as your penis or your feet
Knowing if you’re at higher risk for Dupuytren’s contracture may make you more aware of early signs and symptoms like tender nodules or thickened bands in your palm of your hand
“Early in the condition, tender nodules in the palm may make gripping painful,” Dr
Evans says
FACT The Last Two Fingers Are Most Often AffectedDupuytren’s contracture usually strikes the ring and pinky fingers, but any finger can be involved
The condition may affect both hands, although one is usually worse than the other
As Dupuytren’s contracture progresses, it can become harder to use your hands, and you may start to feel clumsy and unsafe
Although Dupuytren’s usually isn’t painful, simple tasks like washing dishes, buttoning clothing, shaking hands, putting on gloves, or using pockets may become difficult to do
TIP Seek Dupuytren’ s Contracture Treatment PromptlyAll treatments for Dupuytren’s contracture work better before severe contraction sets in
“Some people wait too long to see a doctor because they can get by with a partial grip for a long time,” Evans says
It’s important to monitor Dupuytren’s contracture closely and start treatment as soon as problems surface
Once you progress to full Dupuytren’s contracture, you have fewer options to correct the hand deformity
FACT Dupuytren’ s Can Be UnpredictableThe course of Dupuytren’s isn’t the same for everyone
Some people never develop complete contracture and don’t need treatment
If Dupuytren’s contracture treatment is needed, however, there are several options available ranging from simple office procedures to complex open surgery
“Reasons for treatment are if nodules are causing pain or if fingers have started to curl into the palm,” Evans says
TIP Don’ t Treat Dupuytren’ s Contracture On Your OwnOnce you have Dupuytren’s, there’s nothing you can do on your own to stop it
“Trying to force fingers open with splinting or stretching can cause trauma that may make the condition worse,” Evans says
“You can try hand massage or heat if it helps with discomfort, but it won’t change the course of Dupuytren’s
” Hand exercises may be used as part of physical therapy after Dupuytren’s contracture treatment to strengthen your hand and help it heal properly
FACT Your Doctor Can Help With ReliefIn-office procedures that your doctor can use to treat Dupuytren’s include needle aponeurotomy, steroid injections, and enzyme injections
In the case of needle aponeurotomy, a long needle is inserted through the skin of the palm to soften and break up the bands of tissue that are contracting the fingers
“This procedure has an easy recovery but a high recurrence rate,” Evans says
“Afterwards, the fingers can often be manipulated back into place
You can feel the bands giving way as the fingers are released
” TIP Ask About Enzyme InjectionIn another office procedure called collagenase (enzyme) injection, your doctor can inject a solution into the palm of your hand to dissolve the thickened tissue and relieve the contraction — a procedure that’s used for more severe contractions, Evans says
A 2013 study on collagenase injections for Dupuytren’s contracture, published in the Journal of Hand Surgery, found that of 587 people offered this treatment, 92 percent were either very satisfied or quite satisfied with the results
However, the rate of recurrence was about 35 percent; some recurrence is found in all Dupuytren’s contracture treatments
FACT In Advanced Cases Surgery May Be Needed”Open surgery may be done to cut the bands of thickened tissue in the hand,” Evans says
In severe cases of Dupuytren’s contracture, it may be necessary to remove as much of the affected palmar fascia as possible
This type of surgery can be compared to weeding a garden: “The weeds tend to come back, especially if you don’t get them all out,” he says
In addition, the surgery is extensive and may require a skin graft to close the palm
TIP Ensure A Good RecoveryAlthough hand splinting and stretching exercises aren’t helpful before surgery for Dupuytren’s contracture, they’re important after this type of treatment
Work closely with your doctor to lessen the chances that the condition will return
This may include six weeks of physical therapy with hand massage and stretching exercises
You may also need to wear a hand splint at night for up to six months after surgery
Follow all of your doctor’s orders for the best recovery possible
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