Dupuytren’s Contracture
WHAT IS DUPUYTREN’S CONTRACTURE?
Dupuytren’s contracture is a disease that can lead to limited use of the hand. This may happen when certain tissue in the palm thickens. While it rarely causes pain, Dupuytren’s contracture can make it hard to straighten the fingers.
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WHO GETS IT?
People whose families come from northern European countries are more likely to get Dupuytren’s contracture. Also, men are more likely to get this problem than women.
WHAT ARE THE SIGNS AND SYMPTOMS?
Dupuytren’s signs and symptoms start slowly. They can steadily progress. But they also may stop before they limit hand use. Signs and symptoms include:
- A hard lump forming on your palm
- Inability to place your palm flat on a surface
- Scar like bands forming across your palm
- Fingers bent toward your palm
- Hand pain (less common)
TREATING DUPUYTREN’S CONTRACTURE
If use of your hand is limited, your doctor may recommend treatment with an injection or surgery. These treatments help many patients regain a better range of finger motion. In either case, though, symptoms may come back again in a few years.
HAVING AN INJECTION
With this treatment, a substance is injected into the hand. This substance helps break apart thickened tissue.
You need to elevate your hand and avoid moving your fingers for a day or so. You then return to the doctor to be sure the tissues have released. You may need to wear a splint for a time afterward.
INJECTION RISKS & COMPLICATIONS
- Allergic reaction to the injection
- Skin irritation or swelling
- Tendon rupture or ligament damage
- Nerve damage
- Severe bleeding or bruising
HAVING SURGERY
Surgery removes some of the palmar fascia. This can take a few hours. You may be awake but drowsy or completely asleep during surgery. In most cases, a “zigzag” incision is made to reach the fascia.
When surgery is complete, part of the incision may be left open to allow drainage. It will close on its own as you heal. A thick bandage or cast will be placed over your hand and forearm. You will likely go home the same day.
AFTER SURGERY
In the first few days, keep your hand elevated to reduce swelling. Also, take any pain pills you may have been prescribed. If you’re asked to use ice, follow your doctor’s advice.
In about a week, your stitches will be removed. You then may need to wear a splint. Soon, you’ll start hand therapy and exercises that can help you heal.
SURGERY RISKS & COMPLICATIONS
- Stiff fingers
- Thick scarring on palm
- Nerve damage
- Swelling around finger joints
- Impaired blood flow to hand
- Long-term pain in hand (rare)