What is Dupuytren’s contracture?
A painless thickening and tightening (contracture) of the fibrous tissue under the skin of the palm that can cause the fingers to curl. These contractures develop gradually over years, and commonly affect the fingers. It often runs in families (hereditary), and is associated with drinking alcohol, diabetes, and epilepsy medications. It is more common in men over 40 years old, and those of Northern European or Scandinavian (Swedish, Norwegian, Finnish) ancestry, which is why it is also called “Viking’s disease”.
What are the symptoms?
- Small lumps in the palm that may or may not be painful at first.
- The lumps form tough bands of tissue under the skin.
- As the bands contract, the fingers curl towards the palm.
- Difficulty straightening the finger and grasping objects.
- Symptoms may also occur on the sole of the foot and the penis.
What medical tests will I need?
- X-Rays: to make sure the hand bones are normal.
- Table top test: Xiaflex or surgery are appropriate only when you are unable to completely flatten your hand against a table top
What do I need to know about Xiaflex®?
- This is the first and only injection approved by the FDA to treat Dupuytren’s contracture.
- It is injected directly into the bands in the palm.
- During the several hours following the injection, the enzyme dissolves the bands, allowing the finger to straighten.
- You will return the next day for manipulation of the finger into a fully straightened position.
- This procedure is performed in the doctor's office, and is associated with less pain and swelling than with surgery.
What do I need to know about surgery?
- You will be contacted within 2 weeks after your pre-op appointment for pricing and scheduling.
- The surgery will last less than 60 minutes and you will go home the same day.
- There are no restrictions on lifting things, but you will not be able to move the fingers for 1 week.
- Your surgeon will make small incision in the palm over the bands and remove them, and send the tissue to a pathologist for further analysis.
- At your 1 week follow up visit, the bandage will be removed, your incision will be inspected, and you will begin finger range of motion.
- You will wear a brace at rest and at night to keep your finger(s) as straight as possible.
- You will wear a brace at rest for 1 month.
- If you have limited range of motion after the surgery, you may need occupational therapy.