Dupuytren’s contracture is a debilitating hand condition that develops slowly over a period of years, gradually deforming the hand due to knotty nodules of tissue that form in the palm. These knots pull down the fingers into a permanent bent position.
This continues to create thick, cord-like fibrous tissues in the palm near the smaller fingers, thereby affecting them so that even with effort, they cannot be straightened.
This eventual deformity can affect everything from putting your hand into your pocket to putting on gloves, shaking hands, or washing your face. Dupuytren’s contracture usually affects one or two fingers, the ones farthest from the thumb.
Symptoms of Dupuytren’s Contracture
Initially, small nodules of thick corded tissue appear in the palm of the hand. As it progresses, these nodules grow in size.
The skin can take on a puckered or dimpled look with firm knots of tissue in the palm. These lumps may be sensitive to the touch, but they are normally not painful.
In later stages of the condition, these knotted cords of tissue pull the fingers toward the palm and cannot be pulled back straight again until you receive medical treatment. It becomes impossible to press your hand flat on a level surface.
Normally, this condition is limited to the pinky and ring finger, although in some cases other fingers may also be affected. It can appear in both hands, although usually one hand is affected more severely.
What Causes Dupuytren’s Disease?
While doctors and researchers do not yet know the reason why it occurs, they have identified many risk factors and groups who are more likely to be affected:
- Age – Men over the age of 50 are the most commonly affected group
- Ancestry – People of Northern European descent have a higher risk of developing the condition
- Family History – The condition runs in families
- Tobacco and Alcohol Use – The microscopic changes in blood vessels of smokers and drinkers may be a factor in triggering Dupuytren’s
- Diabetes – People who have any type of diabetes have an increased risk of developing the condition
Treatment for the Hand Condition
Treatment involves a doctor breaking up the cords that have formed in the palm. (Do not try this yourself, or you can cause permanent injury and impairment.)
This can be done a few different ways, depending on the severity. The most common method is called needling, in which the doctor uses a large-gauge needle to poke holes into the fibrous cords to break up the tissue. This method provides a 3- to 5-year window where symptoms will disappear.
In the fourth or fifth year after treatment, chances are the contracture will repeat itself again. Advantages to needling are that it can be done on several fingers at once; disadvantages are that certain places in the hand cannot have needling performed for fear of damage to a nerve or a tendon.
Other treatments involve surgery, and this is usually reserved for more severe or advanced cases. The palm is cut, and the knotted tissue is removed – resulting in long-lasting relief. Physical and occupational therapy are required after the procedure.
Hand Surgeon in Sarasota
If you think you may have Dupuytren’s contracture or another hand problem, contact Intercoastal Medical Group. We have more than 100 medical providers in convenient locations across Manatee and Sarasota Counties.