Treating Dupuytren’s Contracture: Know Your Options

Treating Dupuytren’s Contracture: Know Your Options

Your hands do so many jobs during the day, from hanging a picture on the wall to preparing dinner, that you probably take them for granted. However, when you feel a lump in your palm or are unable to stretch out your fingers completely, you know something is wrong. It’s time for a visit to the doctor.

Our board-certified orthopedic surgeons at Georgia Hand, Shoulder & Elbow are the experts you need to see when you have a musculoskeletal issue. The problem with your hand may turn out to be Dupuytren’s contracture. This condition is characterized by a hard band of tissue below your fingers. It may cause your fingers to curl inward or sideways, making it impossible to stretch out your fingers completely. Using your hands to accomplish daily tasks becomes difficult. 

Why does Dupuytren’s contracture occur? 

There’s a genetic link to Dupuytren’s contracture; you’re more likely to have it if other close family members have it. It’s also associated with being older, male, and of Northern European descent. You’re also at greater risk if you smoke or have diabetes. 

In terms of the physical change in your hand, your body isn’t regulating collagen production as well as it should. You’re producing an excess of collagen, a key protein in your skin and other parts of your body. 

Treatment options for Dupuytren’s contracture

Your physician asks you to perform certain motions to determine the flexibility and strength in your hand. He notes the degree to which your fingers are curling and the presence of any nodules or bands of tissue on your hand. 

Depending on your age, your response to medications, and the severity of your condition, your doctor recommends one or more treatment options. 

Enzyme Injections

Your doctor may recommend injecting an enzyme called collagenase into the tight band of tissue on your hand. The enzyme breaks down the cell structure of the affected tissue and helps regenerate healthy tissue. It works overnight, and you return to your doctor within the next couple of days. He manipulates your fingers and hand to free the contracted tissue. 

The collagenase injection is a minimally invasive procedure that is easily performed in the office. You may need more than one injection to ease the contracture. The procedure can be repeated if the condition reoccurs, and it’s much simpler than surgery. 

Your doctor likely is going to recommend specific stretches for you to do once the inflammation in your hand has calmed down; he may also recommend physical therapy or a splint after the injections. 

Needle aponeurotomy

Needle aponeurotomy is another minimally invasive treatment. Your physician uses the tip of a hypodermic needle to make tiny wounds in the skin in the affected area. This cuts the cords of tough tissue that have contracted in several places. Your doctor then straightens out your fingers. He may give you a steroid injection to calm inflammation. 

Needle aponeurotomy is less costly than collagenase injections, and you’re done in one appointment. It’s also a safe, simple procedure. Your physician decides whether your type of Dupuytren’s contracture can be treated with this option. 

Surgery 

If your condition has progressed and is severe, your doctor may recommend surgery. He explains which type of surgery would be most beneficial for you. 

Fasciotomy 

You’ll receive a local anesthetic for this procedure. After making an incision in your palm, your doctor separates the tough cords of tissue. Your doctor provides you with a splint to wear as you heal. 

Subtotal palmar fasciectomy 

Your doctor may select this surgical option if your condition is very severe. Instead of separating the cords of tissue as in a fasciotomy, your doctor removes the excess tissue in order to straighten out your fingers. To do this, he may need to make an incision across your hand that is a “zig-zag” cut. Your wound may be left open to heal, or you may receive a skin graft if that’s needed to complete healing. You wear a splint during recovery. 

Call or book an appointment online with Georgia Hand, Shoulder & Elbow today for all of your musculoskeletal needs. We have offices in Watkinsville, Marietta, and Atlanta, Georgia.

You Might Also Enjoy...

How Do I Treat Tennis Elbow?

Elbow pain can be disabling. If you’re having discomfort in your elbow, you may also be experiencing difficulty in everyday movements that require its use — for example, brushing your teeth. You may have tennis elbow.

GHSE Hosts Hand2Hand Atlanta 2019

On November 9, 2019, Georgia Hand, Shoulder & Elbow will be hosting a day of surgery at Georgia Surgical Center on Peachtree located at 2061 Peachtree Road in Atlanta.