Dupuytren’s disease is an abnormal thickening of fascia, the tissue just beneath the skin. This thickening occurs in the palm and can extend into the fingers.
Dupuytren’s disease may cause rope-like cords and lumps to develop that can cause the fingers to bend inward, causing what is known as Dupuytren’s contracture. Although Dupuytren’s disease may involve the skin, the deeper structures, such as the tendons, are not directly involved.
Occasionally, Dupuytren’s disease will cause thickening on top of the finger knuckles (knuckle pads), nodules or cords within the soles of the feet (plantar fibromatosis). There is typically little or no pain.
Causes of Dupuytren’s Disease
The cause of Dupuytren’s disease is unclear but may be related to certain biochemical factors within the involved fascia. Dupuytren’s disease is more common in men over age 40, people who consume alcohol, diabetics and in people of northern European or Scandinavian descent.
There doesn’t seem to be any correlation between hand injuries and Dupuytren’s disease. There is also no evidence specific occupational exposures lead to a higher risk of developing Dupuytren’s disease.
Treatment for Dupuytren’s Disease
In mild cases in which hand function is not affected, your Midwest Orthopedic Specialty Hospital doctor will simply monitor the situation. For more severe cases, you and your doctor will consider other treatment options.
One of the more common Dupuytren’s disease treatments is collagenase injection in which a small amount of medicine is injected into the tissue, weakening the tissue so that the finger can be straightened. In addition, treatment can include needle aponeurotomy – a method where a needle is placed through the skin and used to cut the Dupuytren’s disease tissue.
Surgery is recommended when your doctor has confirmed through measurements over time that your Dupuytren’s disease is progressing. Some patients turn to surgery when hand function is limited, such as experiencing difficulty in grasping objects or putting their hands in their pockets.
Surgery for Dupuytren’s contracture divides or removes the thickened bands to help restore finger motion. Sometimes the wound is left open and allowed to heal gradually. Skin grafting may also be needed during surgery.
What to Expect After Surgery
Some swelling and soreness are expected after surgery, but severe problems are rare. After surgery, elevating your hand above your heart and gently moving your fingers help to relieve pain, swelling and stiffness. Physical therapy may be helpful during recovery after Dupuytren’s disease surgery. Specific exercises can help strengthen your hands and help you move your fingers.
Most people will be able to move their fingers better after surgery, and significantly less inward curling is typically reported. However, approximately 20 percent of patients experience some degree of recurrence of Dupuytren’s disease, which could require additional surgery to correct.