Dupuytren's

Dupuytren's disease is a condition where the connective tissue that holds your skin onto your hands thickens and progressively tightens. As it tightens, it causes the joints on your hand to bend more and more, making certain tasks more difficult. While only one or two fingers are usually involved, in some cases it can involve almost all the fingers on both hands.

Cause

No one knows what causes this disease but we know that it is more common in people with Northern European heritage. It can be associated with certain conditions such as liver disease, though the vast majority of people who have Dupuytren's are otherwise quite healthy. There are some links in recent literature linking the disease to a remote history of soft tissue trauma to the hand – a crush for example. Finally, it seems to run in families and most people have a relative or two who have the same problem.

Treatment

In early stages of Dupuytren's, no treatment is necessary if there isn't any joint bending. Occasionally the hand's lumps or bands are painful and need to be treated but the condition is usually quite pain-free and slow to develop. Trying to stretch your fingers on a flat surface and massaging the bands can help slow the disease progression. There are also some encouraging studies about a treatment where a drug is injected to dissolve certain types of bands but this method is not currently covered under the BC health plan.

If the contractures become more serious, then surgery is often the best choice.

Surgery

Dupuytren's can be treated by breaking up the cord to reduce joint contracture - either with a needle or limited incisions. More aggressive surgery involves removing the whole cord and possibly the skin associated with it. Your surgeon will discuss which option they think is better for your particular condition.

Recovery

Most people will need a couple of weeks off after the procedure treating Dupuytren's. In some cases, there may be numbness to the treated fingers for a few days to weeks. Physiotherapy and splinting is often required, especially in more severe cases.

Possible Complications

As with any surgical procedure, there is a risk of infection. As mentioned earlier, post-operative numbness can occur but usually only for a short period of time. Problems with the skin pulling open after surgery can be seen in rare patients but usually heal without further surgery. Those with severe disease causing significant joint tightening might not get full mobility after the surgery. Disease recurrence is also seen, especially in younger patients. Your surgeon will discuss other possible complications at the time of your consultation.