Dupuytren’s disease, also known as Dupuytren’s contracture, is a hand condition that affects the connective tissue beneath the skin of the palm and fingers. This condition develops gradually, leading to thickened and tightened cords of tissue within the hand. As the disease progresses, it can cause the fingers (most commonly the ring and pinky fingers) to curl inward toward the palm. This condition is not usually painful, but can significantly impact hand function and quality of life.
Dupuytren’s disease primarily affects people over 40 and is more common in men than women. While the exact cause of Dupuytren’s disease is unknown, genetics, family history, and certain lifestyle factors may play a role in its development. Understanding the condition, recognizing its symptoms, and seeking early evaluation are essential for maintaining proper function of the hand. Comprehensive care for Dupuytren’s disease and other hand or upper extremity conditions is offered by our hand specialists at OrthoGeorgia. At our offices throughout Central GA, we help restore hand function and improve quality of life for patients of all ages.
What are the Symptoms of Dupuytren’s Contracture?
Dupuytren’s disease progresses in stages, with symptoms ranging from mild to severe. The condition usually begins subtly, with patients often missing the early signs. Symptoms may worsen over time; however, the rate of progression varies greatly between individuals. Common symptoms include:
Lumps in the Palm: The first noticeable sign is often small, firm nodules or lumps under the skin in the palm. These lumps are usually painless, but may feel tender initially.
Finger Curling: The most significant symptom is the bending or curling of one or more fingers toward the palm, making it difficult to straighten them fully.
Thickened Skin: Over time, the skin on the palm may become thickened or puckered.
Formation of Cords: As the disease progresses, thickened tissue forms cords that can extend from the palm to the fingers.
Reduced Hand Functionality: Patients may find it challenging to grip objects, shake hands, or perform other daily activities requiring full range of hand motion.
How is Dupuytren’s Disease Diagnosed?
Diagnosing Duputren’s disease usually begins with a thorough medical history and physical examination by one of our hand specialists. Early diagnosis allows for patient education and management options so that hand function is maintained. Your doctor will evaluate your palm and fingers, checking for lumps and thickened cords. Diagnostic steps may include:
Tabletop Test: This simple test determines if a patient can lay their hand flat on a table. If the hand cannot fully flatten, it may indicate Dupuytren’s contracture. Usually no intervention is needed if the patient can lay the hand flat on an even surface.
Range of Motion Assessment: The doctor may assess finger mobility to understand the extent of the contracture.
Additional Imaging: In most cases, imaging studies like X-ray or MRI are unnecessary, as the condition is diagnosed based on clinical presentation. Your doctor will let you know if additional imaging tests are needed to rule out other hand issues.
Treatment for Dupuytren’s Disease in Central GA
At OrthoGeorgia, we specialize in diagnosing and treating hand and upper extremity conditions like Dupuytren’s disease. Our team of experienced hand specialists in Central Georgia offers both nonsurgical and surgical treatment options catered to each patient’s individual needs. The goal of treatment is to manage symptoms, improve hand function, and prevent further progression. The appropriate approach depends on the severity of the condition, the extent of finger contracture, and how it affects the daily life of the patient. Dupuytren’s contracture may recur or progress with all treatment options.
Nonsurgical Treatment for Dupuytren’s Disease
In the early stage of Dupuytren’s disease, nonsurgical treatments may help slow progression and alleviate symptoms. While these treatments cannot reverse the condition, they may delay the need for surgery. Conservative treatment options include:
Steroid Injections: Corticosteroid injections into the nodules may reduce inflammation and slow disease progression. This treatment can also temporarily relieve discomfort.
Enzyme Injections: Collagenase clostridium histolyticum (Xiaflex) is an FDA-approved enzyme injection designed to break down the thickened cords of tissue in Dupuytren’s contracture. This minimally invasive procedure is typically followed by manual manipulation to straighten the affected fingers.
Dupuytren’s Disease Surgery
For more advanced cases where nonsurgical treatments are insufficient, surgical intervention may be necessary. Surgical options aim to remove or release the thickened tissue and restore finger mobility. Surgery is the most invasive and has the lowest recurrence. Common surgical procedures performed to address Dupuytren’s disease and contracture include:
Subtotal or Total Fasciectomy: During this more extensive procedure, the surgeon removes the thickened tissue bands entirely. This approach may be required for severe cases and offers a longer-lasting solution.
Dermofasciectomy: This procedure involves removing the diseased tissue and covering the area with a skin graft. It is usually recommended for recurrent or aggressive cases.
Recovery time from Dupuytren’s disease surgery varies, but most patients regain significant hand function with proper post-operative care and hand therapy.
Other Hand and Upper Extremity Conditions We Treat at OrthoGeorgia
At OrthoGeorgia, we are committed to providing comprehensive, compassionate care for all hand and upper extremity conditions. Whether you’re dealing with Dupuytren’s disease or another issue, our team is here to help you regain function and improve your quality of life. Dupuytren’s disease is just one of many hand and upper extremity conditions treated at OrthoGeorgia. Our comprehensive care in Central GA extends to a wide range of issues, including:
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