Dupuytren’s Disease

 

Dupuytren’s disease is a common condition affecting people of Northern European descent. It is a genetic disease which usually starts as firm nodules just under the skin in the palm, and gradually grows into tough cords which extend into the fingers causing them to bend. If you are genetically predisposed, trauma or surgery can trigger growth of the disease. People affected often say it causes problems shaking hands, washing their face and getting hands into pockets.

 

Treatment:

In the early stage, a watch and wait approach is adopted. There is nothing you can do to stop the growth of this.

When the cord starts to bend the finger, treatment is advised before the contracture gets too severe. This may be a fasciectomy, fasciotomy or collagenase injection depending on the individuals pattern of disease.

Hand therapy with splinting and exercises is required after treatment.

 

Postoperative risks and complications:

Swelling and stiffness – keep your hand raised and exercise your fingers to prevent this

Scars – will be firm and lumpy initially, and sometimes sensitive, but with regular scar massage will fade and soften with time

Numbness or pins and needles – often short term due to swelling around the nerve and fully recovers, but rarely due to damage to the nerve

Recurrence – as this is a genetic disease, there is no cure so the disease process will continue in the same finger or other fingers

Inability to completely straighten the finger – particularly for those whose contractures are severe and longstanding, but function will improve

Complex Regional Pain Syndrome (CRPS) – a complication of any upper limb surgery (<5%), which is unpredictable and causes swelling, stiffness and pain. This is treated with different Hand Therapy techniques.

 

More information:

http://www.bssh.ac.uk/patients/conditions/25/dupuytrens_disease

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