Dupuytrens Contracture

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First diagnosed and described by Napoleon's personal physician in 1831, Dupuytren's contracture is a hand deformity that affects the connective tissue under the skin of the palm. While there is no cure, our surgeons offer Dupuytren's contracture treatment, including surgery, in New Jersey.

What is Dupuytren's Contracture?

Dupuytren’s contracture is a condition that involves the fascia. This tissue is found in nearly every part of the body. It sits below the skin. Under certain conditions, the fascia can become abnormally thick in the palm of the hand. A lump or area of thickness may develop at the base of the fingers, causing one or more fingers to contract or pull into an abnormal sideways position. Dupuytren’s contracture usually affects the ring or little finger. It may occur on both hands. In rare instances, Dupuytren’s contracture has occurred on the feet.

Dupuytren's contracture begins when knots of tissue form in the palm, eventually developing into a thick cord that can pull one or more fingers (most often the ring and pinky fingers) into a bent position. Once the fingers are bent, they cannot be straightened. This renders everyday activities such as shaking hands, placing your hand in your pockets, putting on gloves or grasping large objects extremely difficult. Dr. Bidic has extensive experience and is fully certified in the surgical and non-surgical treatment of this condition, ranging from the latest FDA-approved collagenase injections (XIAFLEX®) to in-office needle aponeurotomy to outpatient surgery for recurrent cases.

What are the Symptoms of Dupuytren's Contracture?

There are symptoms that can indicate Dupuytren’s contracture long before the finger starts to curl toward the palm. These include nodules, lumps, or firm bands of tissue on the palm of the hand. The skin may appear thicker in the affected area. Puckering of the skin can also occur. If thick cords form, they may run from the palm up the finger, causing bending. This condition is usually not painful, though some patients do express discomfort. Before severe bending develops, symptoms may include an inability to open the hand fully or place a hand flat against a surface. You may notice that it's difficult to put your hands in your pockets or hold large objects.

What Causes Dupuytren's Contracture?

Research has yet to identify a known cause of Dupuytren’s contracture. It is thought to run in families. Factors that may contribute to this condition include:

  • Being older
  • Being male
  • Being of Northern European or Scandinavian descent
  • Taking seizure medication
  • Being diabetic
  • A family history of Dupuytren’s contracture
  • Smoking
  • Excessive alcohol consumption

How is Dupuytren's Contracture Diagnosed?

Having a lump on your palm does not mean you have Dupuytren’s contracture. A qualified hand surgeon can diagnose this condition by carefully reviewing your medical history, symptoms, and family history. A physical examination of the lump or thickened tissue, along with your consultation, may be enough to reach an accurate diagnosis. Your doctor may also order x-rays or another type of imaging to get a better understanding of the mass.

What are the Treatment Options for Dupuytren's Contracture?

Your doctor may recommend simply waiting and watching the lump or mass if you have good hand function. It is possible to try to stretch the fingers and hand using simple exercises you can perform at home. You might also splint the finger. However, neither of these remedies is proven to prevent the worsening of the conditions. If the contracture affects hand function, your doctor may suggest nonsurgical or surgical treatment.

Nonsurgical treatments for Dupuytren’s contracture include:

  • Needle fasciotomy. After numbing the affected area, the doctor uses a needle to sever the cord at multiple locations. They then stretch the finger, breaking the cord and restoring a straight position. It is possible that the cord will return at some point.
  • Collagenase injection. In this procedure, the doctor injects collagenase, which dissolves the cord. To prevent swelling, the doctor may wrap the hand after administering the injections. A few days after these initial injections, a second round of injections is administered. At that time, the doctor will stretch and straighten the finger to break the cord.

Surgical treatment for Dupuytren’s contracture may include:

  • Fasciotomy is a procedure in which the thick cords are cut but left in place. Because the bands are not removed, the contracture could recur.
  • Fasciectomy is a procedure in which the cords are cut and removed, along with any hard nodules that have developed.

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Is Dupuytren's Contracture Dangerous?

This condition is not deemed dangerous, no. However, the chord-like formations can deform the finger to a degree at which it becomes difficult to perform simple tasks.

If you are suffering from a debilitating deformity, choose a hand surgeon in New Jersey with experience and abilities that exceed your expectations. Request your consultation online or call (866) 749-2812 to schedule your appointment.

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