Dupuytren’s contracture is a common disease that causes the fibrous tissue in the palm and fingers to shorten and thicken. This pulls the fingers toward the hand and the person is unable to completely stretch them out. While there are no known causes for the disease, it is common in men older than 40, people of European ancestry and those who smoke, use alcohol, or have diabetes.
Dupuytren’s disease is usually painless. Symptoms develop gradually. Early signs include a tender lump in the palm of the hand or well-defined thickenings over the finger joints, and lumps on the palm. The fingers most commonly affected are the ring and small fingers. As the disease progresses, it becomes harder to straighten the fingers. People have trouble grasping objects and the flexed finger(s) get in the way when using their hand.
There is no permanent cure for Dupuytren’s contracture, but it can be treated in several ways. Surgery may not be necessary if the lumps don’t interfere with use of the hands. In this case, there are two non-surgical treatments.
The first treatment is called needle aponeurotomy. This is an office procedure using a needle to make multiple passes through the abnormal tissue in the palm to weaken it, allowing the Dupuytren’s cord to be ruptured. This treatment is most useful for people with a small area of disease or those who can’t undergo surgery.
The second non-surgical treatment is injecting an enzyme into the diseased tissue. The enzyme breaks up the collagen in the cord, allowing the finger(s) to extend after 24 hours. This procedure may cause numbness or an allergic reaction and some people need more than one injection to completely release the finger(s). Symptoms may reoccur with both of the non-surgical treatments since the diseased tissue is not removed.
Surgery is recommended when the disease has progressed to the point that the person has lost substantial use of their fingers. Surgery is normally carried out under local anesthesia or general anesthesia on an outpatient basis. During surgery, the doctor removes the scarred tissue to free the fingers.
Our experienced hand surgeons can help determine if you have Dupuytren’s disease and how best to treat it. Our office is located in Danbury, Connecticut.