Dupuytren's Disease vs Contracture
Dupuytren’s Disease is a condition that results in the development of fibrous cords and nodules in the connective tissue of your palm and fingers. In some patients this condition progresses to Dupuytren’s Contracture which is the pulling of your finger toward the palm.
This condition is not painful but if contracture develops this can lead to poor hand function. In severe cases the entire finger may be contracted into the palm with an inability to straighten the finger.
Treatment options include percutaneous aponeurotomy, Collagenase, and surgery.
Percutaneous aponeurotomy involves an injection to numb your finger followed by many needle sticks to break the thick cord in your palm/finger. The finger is then extended to try and further break the cord.
Collagenase is another nonoperative treatment. Collagenase is injected at the site of the cord. It accomplishes its action by the use of an enzyme to break down the thick cord. Two days after injection you are brought back to the office to have your finger placed in extension to break the cord. Occasionally skin tears may occur which may require dressing changes.
There are 2 surgical options: Incisional procedures and excisional procedures. The incisional procedures involve cutting the contracted cords to allow for finger extension. The excisonal procedures involve the removal of the contracted cords to allow for finger extension.
These options will be discussed in detail during your office visit.
Recovery after surgery
If surgery is performed you will be seen by a hand therapist and splinting may be employed. We will recommend that you move the fingers in order to avoid stiffness. Unrestricted work is usually started at 6 weeks post-operatively.