Dupuytren Procedure Specialist

What is Dupuytren’s contracture?

Dupuytren’s contracture is a disease that affects the fascia of your hand. Your fascia is a layer of fibrous tissue that lies just beneath your skin, including the skin of your fingers and palm. Dupuytren’s occurs when your fascia thickens and then tightens over a period of time. 

As the fascia constricts, it pulls your fingers inward, toward your palm. This can occur very slowly, and many people don’t seek treatment in the early stages. 

What are some symptoms of Dupuytren’s contracture?

The earliest sign of Dupuytren’s contracture is often small nodules or lumps in the palm of the hand. They sometimes feel tender to the touch in the early stages, but those sensations often fade over time. 

Contracture begins as your fascia tightens. One or more fingers might begin to be pulled inward toward your palm. This most often occurs with the ring and little fingers but could affect any finger or your thumb. 

You might encounter difficulty fully extending your fingers, or it may become challenging to grasp objects or perform normal daily tasks. It’s important to seek care if symptoms begin to interfere with your normal daily routines. 

How is Dupuytren’s contracture treated?

In the early stages, observation is indicated. The “table top test” is a useful way to assess when an evaluation is indicated.  If you can not put your hand flat on a table, call the office for an appointment.  Sometimes, when appropriate, an office-based procedure can alleviate the issue.  Other times surgical treatment is indicated.

Fasciotomy

The office-based procedure often involves injecting a medicine called Xiaflex into the cord which weakens it.  Then once the enzyme has weakened the cord, the finger can be extended in the office after injecting a local numbing medicine

Subtotal palmar fasciectomy

Another surgical approach is called subtotal palmar fasciectomy. This requires an incision to gain access to the underlying fascia, then removal of as much abnormal tissue as indicated. The incision is often in a zig-zag pattern, and a skin graft is sometimes needed to help your body heal.

Splinting is commonly required after any procedure for Dupuytren’s contracture. 

If you require surgery to improve your hand function, adhering to the post-surgical guidelines provided by your surgical team at Braunfels Orthopaedic Surgery & Sports Medicine is a critical part of a successful recovery. It takes time for your body to move through the healing process and avoiding infection and additional injury is central to a positive outcome. 

Don’t live with limited hand function from Dupuytren’s contracture when there are treatments that can help. Schedule an appointment using the easy online booking tool, or call Braunfels Orthopaedic Surgery & Sports Medicine.