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BLOG 249 DUPUYTREN’S CONTRACTURE

January 8, 2020 / Uncategorized

BLOG 249 DUPUYTREN’S CONTRACTURE

Dupuytren’s contracture is a condition marked by tightening of the elastic skin (tissue) found under the skin of the palm and fingers. This tissue is called fascia and is composed of fibers that are like cords which run from the palm to the fingers. However, with this condition, the cords tighten up and contract, which causes the fingers to curl and the hand to make deformed shapes. Severe cases can cause extreme crippling of the hands.

Dupuytren’s contracture can be caused by different biological factors and can be caused by Dupuytren’s disease, but the exact cause is unknown. Certain things such as having diabetes, persons with epilepsy, and drinking a lot of alcohol, can all be possible causing factors. This condition is very common in families, so the leading cause is that is it inherited. Families that have blood lines tied to Scandinavian (Finnish, Norwegian, and Swedish) or are Northern European (Scottish, Irish, French, Dutch, and English) are at higher risk. Males are also more likely to have this hand issue and that risk increases with age, especially over 40.

The initial symptom is spotting visible nodules under the skin of the palm. The bumps can be tender to touch. The bands under the skin eventually become inflexible and cause the bending and curling of the fingers. Soon, it becomes difficult to un-curl the fingers. This is mainly true for the ring and pinky fingers. Both hands are become affected, not just one. Every day tasks start to become harder leading to difficulty picking up objects, putting hands in the pockets, or just getting your I.D. out of your wallet can seem too hard. Shaking a person’s hand is almost impossible.

A doctor will examine the palm and the number of nodules. They might do an assessment of your ability to grasp, pinch and straighten the fingers, as well as to see if you can straighten the fingers. There currently is no cure for Dupuytren’s contracture. It is not life threatening, rather, it can just be disruptive to daily living. It is not recommended to splint the fingers or trying to stretch them straighter. This will only cause increased trauma to the area. Corticosteroids can be injected into the nodule areas if inflammation is painful. This will not straighten the finger, but it will help alleviate pain. Thera are also medications that help dissolve the tissue. This medication is called Xiaflex which helps weaken the tight bands and let the fingers somewhat straighten more. On rare occasions, surgery is needed. This would involve removing the tight bands. The surgery is successful for most people, but one in five people do have the condition return.

We use our hands and fingers so much, making Dupuytren’s a difficult condition to tolerate. It can be frustrating but where there is a will there is a way. Relief is possible and patience is important.

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