Dupuytren’s Contracture is a hand condition that progressively affects the connective tissue beneath the skin, causing it to thicken and form tight bands or nodules on the palm and fingers. This disorder typically affects the ring and pinky fingers, gradually pulling them into a permanently bent position toward the palm. The exact cause of Dupuytren’s Contracture remains unknown. However, it is believed to be associated with genetic factors and environmental influences, such as repetitive hand trauma or chronic overuse.

At North Florida Hand and Wrist, our expert hand and wrist surgeons, Dr. Richard D. Curtis and Dr. Jose Baez, are dedicated to diagnosing and treating Dupuytren’s Contracture using advanced, minimally invasive techniques. Supported by a state-of-the-art facility and a team of committed practitioners, our goal is to deliver the highest standard of care to patients experiencing hand or wrist discomfort.

In this educational article, we will delve into the potential causes, common symptoms, and various diagnostic methods for Dupuytren’s Contracture. We will also explore the wide range of treatment options available at North Florida Hand and Wrist. By understanding Dupuytren’s Contracture and the available treatments, patients can make informed decisions about their hand and wrist health to achieve successful outcomes and improve their quality of life.

Understanding Causes and Risk Factors of Dupuytren’s Contracture

Although the exact cause of Dupuytren’s Contracture is unknown, several factors have been identified as potential contributors to the development of the condition. These factors include:

  1. Genetics: Dupuytren’s Contracture is often hereditary, with individuals of Northern European descent being more susceptible to developing the condition.
  2. Age and gender: The prevalence of Dupuytren’s Contracture increases with age, and it is more commonly found in men than women.
  3. Lifestyle factors: Tobacco use, excessive alcohol consumption, and exposure to hand vibrations have been linked to an increased risk of developing Dupuytren’s Contracture.
  4. Health conditions: Certain medical conditions, such as diabetes, epilepsy, and liver disease, may increase an individual’s risk of developing this progressive hand disorder.

Recognizing Symptoms of Dupuytren’s Contracture

The symptoms of Dupuytren’s Contracture can vary and often develop gradually over several years. Early signs and common symptoms include:

  1. Palmar nodules: Small, firm nodules or lumps may form beneath the skin of the palm. These nodules can be sensitive to the touch but are generally non-painful.
  2. Thickened skin: The skin on the palm may become thick, tight, or puckered, often resembling cords or bands.
  3. Curled fingers: Affected fingers, particularly the ring and pinky fingers, may begin to bend toward the palm, eventually becoming permanently contracted if left untreated.
  4. Limitation of motion: As the contracture progresses, the range of motion in the affected fingers may become increasingly limited, making everyday tasks more challenging.

Diagnosing Dupuytren’s Contracture

To accurately diagnose Dupuytren’s Contracture and determine the most suitable treatment approach, our physicians at North Florida Hand and Wrist will:

  1. Perform a physical examination: During the examination, the doctor will assess the appearance and texture of the skin on the patient’s hand, checking for nodules, cords, or other abnormalities.
  2. Test finger mobility: The physician may ask the patient to place their hand flat on a table or attempt to grasp an object to evaluate the range of motion and functionality of the affected fingers.
  3. Review medical history: A thorough discussion of the patient’s medical history and potential risk factors is essential for an accurate diagnosis and effective treatment plan.

Non-Surgical Treatment Options for Dupuytren’s Contracture

In the early stages of Dupuytren’s Contracture, conservative treatment methods can often be utilized to manage symptoms and slow down the progression of the condition. Some non-surgical treatment options include:

  1. Observation and self-care: If the contracture is not causing significant functional impairment or pain, monitoring the condition and implementing self-care measures, such as gentle stretching and massage, can help alleviate symptoms and prevent further progression.
  2. Splinting and adaptive devices: Wearing a splint or using adaptive tools to assist with daily activities can help maintain finger mobility and improve overall hand function.
  3. Injectable treatments: In some cases, an injectable enzyme called collagenase clostridium histolyticum (Xiaflex®) may be administered by a physician to break down the tough cords that cause finger contracture. This treatment can help restore finger mobility with minimal side effects.

Surgical Treatment Options for Dupuytren’s Contracture

When conservative treatments fail to provide adequate relief or the contracture progresses to a more advanced stage, surgical intervention may be necessary. The most common surgical treatments for Dupuytren’s Contracture include:

  1. Fasciotomy: This minimally invasive procedure involves making small incisions in the hand to release tension in the cords and improve finger mobility.
  2. Fasciectomy: In more severe cases, the entire affected fascia (connective tissue) may need to be removed through a larger incision to restore finger function.

Post-surgical rehabilitation, including hand therapy and occupational therapy, is crucial for optimal recovery and regaining hand function.

Conclusion

Dupuytren’s Contracture, though often harmless, can significantly impact an individual’s quality of life if not properly managed or treated. By understanding the condition’s symptoms, causes, and available treatment options, patients can make informed decisions about their hand and wrist health.

At North Florida Hand and Wrist, our team of skilled hand and wrist surgeons, led by Dr. Richard D. Curtis and Dr. Jose Baez, is dedicated to providing personalized and comprehensive care for patients suffering from Dupuytren’s Contracture or other hand and wrist conditions. With our expert guidance, you can expect a high standard of care on your journey toward improved hand function and pain relief.