Dupuytren’s Contracture is a chronic condition that involves one or more fingers in either hand to bend towards your palm. In particularly severe cases, it can restrict movement and limit the function of your hand, as you may no longer be able to grasp and grip objects.
The condition actually affects about 10 million people in the US alone. If you are experiencing difficulty in straightening some fingers, particularly your index and small fingers, you should see a hand doctor for proper diagnosis and possible correction.
In this article, we will delve deeper and share several facts about Dupuytren’s Contracture.
What causes Dupuytren’s Contracture?
Its underlying disease is called Dupuytren’s Disease, which does not necessarily manifest as a contracture. This disease also affects the fascia, a layer of tissue under your skin that helps anchor your skin and muscle to your bones through tension to maintain your body’s structure, especially for movement. On your hands, it allows you to grip or grasp an object.
In this disease, the fascia begins to thicken and contract, pulling the overlying skin. This usually manifests in pitting on the surface of your palm. Over time, it develops into thick cords that will then pull on one or two fingers towards the palm, involuntarily bending them.
The condition often progresses over a few years, during which patients will notice that it may take some effort to straighten their hands. As the bands of fascia continue to develop into thicker cords, the fingers’ curling will get stiffer and surgery may be needed to correct them.
What causes Dupuytren’s Disease?
The cause is not yet known, but doctors are looking at genetic disposition and other risk factors, such as a history of alcoholism, smoking, diabetes, and epilepsy. Additionally, the contracture and its underlying disease are hereditary. The disease generally affects people in their forties and fifties, and the risk increases as people get older.
How do you treat Dupuytren’s Contracture?
Because there is no known cure for Dupuytren’s disease, the best treatment is to correct the contracture through surgery and non-invasive procedures. Both methods will target the bands of fascia that have formed cords to minimize the restriction of your fingers. Some doctors may first recommend non-invasive procedures if the contracture has not yet progressed to the point where it is restricting the movement of your affected fingers.
The most common non-surgical treatment is Steroid Injection, wherein corticosteroids are injected into a nodule to slow the progression. However, the efficacy of steroids can vary from patient to patient. Additionally, the treatment can only slow down the progression, and you may still eventually need surgery. Another emerging procedure is injecting an enzyme called Xiaflex on your hands to dissolve the cords. Doctors will then manipulate the affected fingers in about 24 hours under local anesthesia, which ruptures the cords in the process.
With long term data about the efficacy of the non-invasive procedures not yet available, most doctors will resort to surgery. Two of the most common surgical treatments are Fasciectomy and Needle Fasciotomy.
Fasciectomy involves making a cut along the palm and the affected finger and removing as much of the affected tissue and cords to straighten your fingers. With Needle Fasciotomy, a doctor inserts a needle into the several places along your palm and finger to cut and loosen the cords – both are outpatient procedures.
However, because Fasciectomy is a more extensive procedure, recovery time can take anywhere from 4 to 12 weeks and will include splinting and hand therapy. There’s also a lower risk of the contracture recurring in this procedure.
Aside from trying to minimize the avoidable risk factors, such as alcoholism and smoking, the best thing to do is to always observe and contact a doctor if you feel any discomfort in straightening your hand. A doctor will know if and when you will need any corrective procedure.
North Florida Hand and Wrist is the leading authority in hand pain treatment in Florida. Get in touch with us today, our specialists are glad to help you!