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What is Dupuytren's Contracture?


Dupuytren’s Contracture is an inherited condition that affects the hands and fingers, causing one or more fingers to bend into the palm of the hand. It can affect one or both hands and sometimes the thumb.

Dupuytren’s Contracture occurs when the connective tissue in the palm thickens, forming small nodules under the skin that make it difficult to move the fingers. Over time, the nodules forms chords of scar tissue. These chords can shorten and pull the fingers towards the palm, making your hand impossible to straighten. These contractures are often mild and painless but they can get worse over time. 

 Dupuytren's Contracture: Who is Affected?

Dupuytren’s Contracture is more common in patients with diabetes mellitus, alcoholism and seizure disorders (otherwise known as epilepsy). The condition is generally more common in men than women and tends to start later in life, appearing in men over 50 and women over 60.

What are the Symptoms?

There are some symptoms attributed to Dupuytren’s Contracture that may be noticed by the patient early on. One of the most common symptoms is difficulty placing the hand on a flat surface. As the fingers are drawn into the palm, it may be more difficult to wear gloves, wash your hands, hold things or put your hands into your pockets.

It is difficult to know how the disease will progress in individuals. Some people only experience small lumps or chords, while others develop severely bent fingers that dramatically impact their ability to carry out daily tasks.

Tests and Diagnosis

Generally, diagnosis of Dupuytren’s Contracture is simple and painless. Doctors can diagnose the condition simply by assessing the look and feel of your hands. Your doctor will compare your hands and check for any puckering in the skin of your palms. He or she will also apply pressure to your hands and fingers to check for any knots of tissue. They might also check to see whether you can place your hand flat on a table top. Not being able to fully flatten your fingers indicates may you have Dupuytren’s Contracture and could require treatment.

Reasons You Might Need Treatment

You will require treatment when it becomes evident that the affected finger can no longer be fully extended. This may be due to scar tissue which has formed in the palm of your hand. Your hand surgeon will discuss the most appropriate course of treatment based upon the stage and pattern of the disease and the joints involved.

The goal of the treatment is to mobilise your hand. However, complete correction may not always be successful. Even with treatment, the condition may still return. Therefore, before your treatment, your surgeon will discuss with you in detail the realistic goals and possible risks you may face as a result of treatment.

Dupuytren’s Contracture NHS Treatment

The NHS will not treat Dupuytren’s Contracture until the angle of the contracture meets their regulations. That is, if the contracture affects the mobility of the hand. As with any NHS treatment, you are expected to first consult your doctor before being treated by a hospital. Unfortunately, the NHS have particularly long waiting lists for surgery and your condition can often worsen significantly during the delay.

Fortunately, McIndoe have no waiting lists and can treat you straight away. Our specialist consultants will see you without delay, assess the severity of your Dupuytren’s Contracture and advise you of the best course of action. Many people avoid private hospitals because they assume they can’t afford the treatment. However, with McIndoe you can be treated by experts at an extremely affordable price.

Treatment Cost at McIndoe

Treatment costs will vary depending on the needs of the patient and individual care requirements. However, the full pricing options will be discussed with you during your initial consultation.

Treatment and Drugs

If the disease progresses slowly, has limited impact on your ability to use your hands and causes no pain, you might not need treatment. Instead, it is best to wait and see if Dupuytren’s Contracture progresses. If Dupuytren’s Contracture progresses quickly, it is best to seek medical advice. Our consultants at the McIndoe Centre are highly-experienced and knowledgeable regarding all Dupuytren’s Contracture symptoms. They would be more than happy to advise you on the possible next steps.

However, should your doctor or surgeon advise treatment there are multiple options, depending on the severity of your condition. Treatment involves removing or breaking apart the chords that are pulling your fingers towards your palm to regain full motion. This can be done in several ways. However, the choice of procedure depends on the individual and their symptoms. Below are the treatments The McIndoe Centre carry out for patients with Dupuytren’s Contracture.

Needling

Needling involves inserting a needle through your skin to puncture and break the chord of tissue that is contracting the finger. The main advantage of this procedure is that it does not require an incision and it can be done on several fingers at the same time. However, physiotherapy is usually required afterward and the condition can recur after the procedure, in which case treatment would need to be repeated. Patients who have had needling carried out may need to wear a splint during recovery during the night to encourage complete healing.

Enzyme Injections

Enzyme injections involve injecting a specific enzyme into the taut chord in your palm to soften and weaken it. This injection allows your doctor to later manipulate your hand and attempt to break the chord to straighten your fingers. The effects of enzyme injections are similar to those of needling.

Surgery

For people with advanced Dupuytren’s Contracture, surgery is often required. The main advantage to surgery is that its results are long-lasting and effective. Recovery following surgery can take up to six months of physiotherapy. Despite patients being able to go home the same day following surgery, strenuous activities are not permitted for a week post operation. However, light day-to-day tasks are not a problem and will not affect your recovery.

Dupuytren’s Contracture surgery involves your surgeon removing the tissue in your palm affected by the disease. In some severe cases, surgeons may remove all the affected tissue, including the attached skin. This surgery is only carried out on patients with extreme cases of Dupuytren’s Contracture.

Recovery Time

To enjoy a full range of movement following hand surgery, it can take up to six months with physiotherapy. However, patients are usually able to go home the same day following surgery and can return to light activities immediately. Strenuous activities are not permitted for a week post operation.

What are the Benefits of Treating Dupuytren’s Contracture?

Treating patients with Dupuytren’s Contracture has many benefits, including:

  • Increased functionality of the hands and fingers.
  • Reduced likelihood of the condition recurring.

To make a fully informed decision regarding Dupuytren’s Contracture surgery, click this link for a guide on surgeries with McIndoe and what to consider before undergoing any kind of cosmetic procedure.

Contact McIndoe Today

If you would like more information about Dupuytren’s Contracture, our specialists here at The McIndoe Centre would be more than happy to advise you. Please call the Helpline on 0800 917 4922 for free and professional advice or submit a contact form here for more information. 

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