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. It often starts as firm lump or nodule in the palm and can later develop into cord like bands that extend up the fingers or thumb. Occasionally the hand’s lumps are itchy but the condition is usually quite pain-free and slow to develop.
Causes of Dupuytren’s Contracture
No one knows what causes this disease but we know that it is more common in people with Northern European heritage. Due to it being more prominent in people with Northern European heritage it is often referred to as “Viking’s disease”.
Dupuytren’s Contracture Treatment
No treatment is necessary unless there are bands causing significant bending of the finger joints. Massage and stretching the fingers generally does not slow the disease progression.
Certain types of bands can be injected with a drug called Xiaflex, but this medication and procedure is not currently covered under the BC health plan. Xiaflex can help dissolve and soften some bands, which can then be further released with a manipulation procedure done by your surgeon.
If the contractures become more serious, then surgery is often the best choice.
Surgery for Dupuytren’s Disease
Dupuytren’s can be treated by breaking up a band to reduce joint contracture – either with a needle or limited incisions. This approach does NOT remove the thickened bands but it breaks them up to allow the finger to extend further.
Open surgery involves removing the whole band and possibly the skin associated with it. Your surgeon will discuss which option they think is better for your particular condition.
Even with open surgery, Dupuytren’s does tend to recur over time and many patients require several procedures in their lifetime.
Dupuytren’s Recovery Process
After the needle release procedure there are often small splits in the skin which take a few days to heal up. Patients are using there hand the next day.
After a Xiaflex injection it is common to have a swollen, bruised palm and stiff fingers. Often this takes a couple of weeks to resolve. A manipulation procedure under local anesthetic is required and usually done 5-7 days after the injection.
After open surgery, it takes a 2-3 weeks for the wounds to heal in most people. The scars can often be sensitive at first and most people feel like it takes 6-8 weeks for the hand to be very functional again.
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.
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.
To learn more about how you may benefit from Dupuytren’s contracture treatment or to schedule a consultation with one of our board-certified plastic surgeons, please contact our Surrey office today.