What You Should Know about Dupuytren’s Contractures
Dupuytren’s disease is an uncommon collagen disorder that occurs in the palm of hand and digits. When it occurs, it is most often seen in people of Northern European or Scandinavian origin, and much less commonly in those with heritage outside of this region. Patients may notice what appears to be thickening of the skin in the palm of the hand in discrete fibrous knots or sometimes as thick cords that may extend across the palm into the fingers. The severity of the disease can vary in individuals, some just having a few knots to more extensive cords that can contract or pull the fingers down towards the palm. While there is no known cure, there are a variety of treatment options.
The severity of the Dupuytren’s contracture can vary and treatment is indicated when the contracture is severe or restricts the normal use of the hand. Collagenase injections and needle release are two common minimally invasive techniques. Both can be performed in the office setting and can provide significant improvement in appearance and function in the appropriately selected patient. For more extensive cases, the cords are removed with surgery in an operation. Recovery for surgery can take several weeks with the assistance of a hand therapist. No matter the treatment, the contractures can recur. With the minimally invasive treatments, results typically last three to five years. Surgery offers the longest period before recurrence, on average at least a decade or longer. Despite a shorter period to recurrence, the collagenase injections and needle release offer the benefit of immediate recovery without surgical healing time or need for therapy.
An evaluation with an experienced hand surgeon can help patients chose the best treatment option for the severity of their contracture. At Hand and Microsurgery Associates, we individualize the treatment plan for each patient based on their specific disease. Our physicians have experience and knowledge with both minimally invasive options as well as surgical management.