Dupuytren’s contracture causes the fingers to develop a flexed posture. The contracture occurs when collagen (a type of glue in our body) is deposited in abnormal quantities. These depositions in concert with a specialized cell called a myofibroblast create the cords (thick rope-like structures felt underlying the skin) and contractures seen in patients with Dupuytren’s contracture. At times, nodules and/or skin pitting may also occur in the hands. Dupuytren’s contracture may be associated with a family history of the disease. There are some individuals who report a history of diabetes, alcoholism, and/or taking anti-seizure medication. Severe contractures may cause the fingertip to press on the palm of the hand and interfere with hand hygiene. In less extreme cases, patients may still experience interference with daily activities. For example, some patients are unable to place their hands in their pockets without difficulty, or lay their hands flat on a tabletop, or open their hands enough to grasp objects such as a football.
Treatment options for Dupuytren’s contracture include observation, collagenase injection, needle aponeurotomy, surgical fasciotomy, surgical fasciectomy, and a variety of other procedures. Post-surgical treatment may include splinting and exercises to assist with mobilization of stiff fingers and reduction of swelling. Discussing your history and symptoms with your treating physician is important when deciding how to proceed. The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician. Outcomes after Hand Surgery treatments vary and risks and benefits should be discussed in detail with your treating physician. Nonoperative treatment also carries risks and benefits which should be discussed with your treating physician.
Disclaimer: This information is not intended to covey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/10/2021 Tanay Amin, MD
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