Dupuytren's Disease

Dupuytren's disease is an abnormal thickening of the tissue beneath the skin in the palm of the hand. It is not a serious condition though can hinder hand movement if left untreated. Hard knots may form under the skin and in some patients can become cords that pass into the fingers. These cords may feel or look like tendons but they actually lie above the tendons. The cords can be painful and may pull fingers down into the palm, which is known as Dupuytren's Contracture. Occasionally the disease can also cause thickening over the top of the knuckles. A similar condition may also occur in the soles of the feet.

Symptoms of Dupuytren's Disease:

  • Pain and tenderness at the thumb side of the wrist.
  • Possibly swelling and redness in the affected area.

Causes of Dupuytren's Disease:

The cause of Dupuytren's disease is unknown and no permanent cure has yet been discovered. It is more common in people with Northern European ancestors. It occurs more often in men and in people over the age of 40. While there is a link between Dupuytren's and Diabetes, there is no clear evidence to link Dupuytren's disease to a specific occupation or injury.

Diagnosis:

A diagnosis of Dupuytren's disease is made by thoroughly examining the hand. Even nodules and cords that are not painful and do not cause finger contractures are easily identified upon observation.

Treatment Options:

While conservative treatment may relieve some of the pain associated with Dupuytren's disease, surgery may be recommended if the disease becomes painful or the fingers start to pull down into the palm - affecting hand function. Dr. Rosen addresses severe contractures with an external fixator called a Digit Widget, which may be used alone or in conjunction with other treatment.

Some patients may also be candidates for a new injection procedure known as XIAFLEX. This recently FDA-approved non-surgical treatment for Dupuytren's disease is injected into the collagen cord of the hand - breaking down the excessive collagen buildup which results in debilitating contractures. 

If surgery is required, it is performed as an outpatient procedure. Following surgery, most patients will need splinting and hand therapy in order to help control scar formation and restore hand function.

 

© Copyright 2015 Dr. Allan Rosen MD