Dupuytren’s disease is the most common hand condition you’ve never heard of. The disease can make fingers permanently bent, making simple tasks difficult, including writing and using hand tools. The disease typically affects the ring finger and the little finger but can affect the fingers you regularly use, such as the thumb and index finger.
Beyond lifting a cup of coffee off a table, it can become more challenging to use your hands for many ordinary tasks, including writing, typing, hand-related sports and exercise, playing a musical instrument, or using hand tools. Over time, the fingers can become frozen in an awkward position and may begin to look like you had a stroke.
How Common Is It?
Dupuytren’s affects at least 10 million Americans, most of whom are elderly. Most persons have a moderate or early illness. Many people have no idea what they have.
What Causes Dupuytren’s Disease?
Dupuytren disease is caused by a problem in the hand tissue that causes cells to stick together. This leads to thickened tissue in the palmar fascia, a surface layer of tissue between the skin and the underlying, more muscular layer. This thickened tissue pulls on the fingers, causing them to bend into a permanently flexed position. The palmar fascia connects the skin to the underlying tissue of the palm and extends to the fingertips, like a spider web.
It supports the skin and acts as a shock absorber and protector of underlying tissues. With the disease, there is a thickening of the palmar fascia. The thickened tissue pulls and tightens the fingers, causing them to bend and become deformed. The tissues also thicken slowly and become very hard, like wood. If the finger is bent permanently, the tissues don’t lengthen. This can cause pain and stiffness, especially in the morning or after activity.
Dupuytren’s disease is thought to be inherited (be hereditary). The precise reason is unknown. It might be caused by cigarette smoking, alcoholism, diabetes, dietary deficits, or seizure medications.
Symptoms
Symptoms are often progressive. They may come and go, but they will get worse over time. Symptoms may vary from one Dupuytren patient to another. The disease may begin in one or more fingers. There may be pain, stiffness, and swelling. The skin may be red and have a lump beneath it. The finger may be bent slightly or severely.
A person with Dupuytren’s may have:
- Fingers bent so that the palm is no longer facing the body; the fingers are straight and pointing away from the body
- Fingers bent permanently and cannot be straightened
- Fingers that feel like they are held in a bent position
- Fingers that become stiff and painful during cold weather
- Minor lumps and redness or warmth beneath the skin in the palm
The symptoms of Dupuytren’s may resemble other hand conditions or medical problems. Always consult your child’s physician for a diagnosis.
Diagnosis
Dupuytren’s disease is diagnosed by a physician, who will first ask the child or parent a series of questions. The physician will observe the hand and fingers and feel the palm tissue to determine if there is thickening. Other tests that are done include x-rays, CT scans, and MRIs.
Treatment
Dupuytren has office and operating room techniques, but only for bent fingers. Doctors consider joint angles, past treatment, and patient preference when prescribing therapy. Most people perform well with procedures, although the outcomes are unexpected and frequently temporary. Repeat treatments are more dangerous and less successful despite all current therapy, those with severe Dupuytren risk becoming incapacitated.
Conclusion
Dupuytren’s disease is a challenging condition, and it is one of the hand disorders that most doctors are often not familiar with. Early Dupuytren is often misdiagnosed as arthritis, callous, or tendinitis. More often than not, the disease does not seriously begin until middle age (30 to 50 years old). Early treatment can improve outcomes and prevent pain and loss of use.
If you’re looking for the best hand specialist, The North Florida Hand and Wrist team of experts is here to relieve you of any pain and discomfort in your hands or wrists. Call us today and set up an appointment!
