Dupuytren’s Contracture

Dupuytren’s Contracture Diagnosis and Treatment

Dupuytren’s Contracture is a hand condition affecting the connective tissue of the palm, causes hand deformity, loss of finger function, and hardening of the affected area. It is a rare condition that is generally not painful, and can make everyday activities, such as straightening the fingers, shaking hands, and putting your hands into your pockets more difficult. The condition generally progresses slowly over the course of several years. In some cases, however, it can progress rapidly over the course of several months. The cause of this condition is not fully known, however, possible contributing factors include family history, alcohol and tobacco use, and diabetes.

SYMPTOMS:
  • Thickening of skin on palm.
  • Formation of a lump beneath skin.
  • Cords of tissue form.
  • Difficulty straightening ring and pinky fingers.
DIAGNOSIS:

At the Fiore Hand & Wrist, testing and diagnosis entails a physical examination of the hands, including evaluating their look, feel and range of motion. A test of one’s ability to flatten the hand palm-side down on a flat surface is often used for diagnosis.

TREATMENT:

In some cases, the condition may not progress enough for treatment to be needed. In other instances, hand surgery or non-surgical treatments may be necessary to relieve the symptoms. 

NON-SURGICAL:

Treatment options include:

  • Steroid injections.
SURGICAL:
  • Removing the banded tissue to restore finger mobility.
  • Dividing the banded tissue to restore finger mobility.

Surgery is reserved for cases in which the fingers are unable to be extended fully. In the past, the skin and all of the diseased tissue was excised, and it was necessary to have skin grafts. Today, this is not necessary and rarely performed. Dr. Fiore conducts most surgery through smaller incisions and focuses on removing the diseased connective tissue, known as fascia. This condition is not cancer so it is not required to remove more than necessary.

In Houston, Dupuytren’s Contracture can now be treated by a recently approved method called Xiaflex (Collagenase). It is an injectable, NON-SURGICAL treatment. The treatment involves an injection about the cord followed by a manipulation of the contracted joint the following day. Most patients have the contracture corrected to 0-5 degrees with 1-2 injections.

The Image below shows a mans hand prior to the treatment.

Dupuytrens Contracture Pre Treatment

The picture below shows the same hand after the injection.

Dupuytrens Contracture Post Treatment

Manipulation after Xiaflex Injection for Dupuytren’s Contracture.

Full range of motion after Xiaflex treatment for Dupuytren’s Contracture.

Patient interview following Xiaflex treatment for Dupuytren’s Contracture.

 

Dr. Fiore specializes in the diagnosis and treatment of Dupuytren’s Contracture. He is board certified by the American Board of Surgery and fellowship trained in hand surgery. For more information on treatment options, or to schedule a consultation, call Fiore Hand and Wrist at (281) 970-8002.

We are conveniently located within driving distance of Cypress TX, Katy TX, Spring TX, Tomball TX, The Woodlands TX, and Houston TX.

For more information please visit Handcare.org.