Treatments for Dupuytren's contracture may include:
- Surgery. This is the most common treatment used for advanced cases.
- Steroid shot (injection). If a lump is painful, a steroid injection may help ease the pain.
- Radiation therapy.
- Enzyme injection.
- Needle aponeurotomy.
It is defined by Dorland as shortening, thickening, and fibrosis of the palmar fascia producing a flexion deformity of a finger. Tradition has it that the disease originated with the Vikings, who spread it throughout Northern Europe and beyond as they traveled and intermarried.
What Is a Contracture? A contracture occurs when your muscles, tendons, joints, or other tissues tighten or shorten causing a deformity. Contracture symptoms include pain and loss of movement in the joint. If this occurs, you should seek treatment right away.
Camptodactyly is a rare condition where a finger — or fingers — is fixed in a bent position at the middle joint, and cannot fully straighten. Affecting less than 1 percent of the population, camptodactyly is most often found in the pinky finger and can occur in one or both hands.
Most contractures can be reversed if detected before the joint is immobilized completely. Contractures occlude the capillaries in the joint. Contractures are often painful, feeling much like cramps that athletes get from overexertion.
A minimum of 2 to 3 hours of daily standing and/or walking is necessary in addition to passive stretching for the control of contracture formation in myopathies. Passive stretching to maintain or improve range of motion is an enormously important component of the program to prevent contractures.
A permanent tightening of the muscles, tendons, skin, and nearby tissues that causes the joints to shorten and become very stiff. This prevents normal movement of a joint or other body part. Contractures may be caused by injury, scarring, and nerve damage, or by not using the muscles.
If your finger is already bent, your doctor may recommend Xiaflex, a mixture of enzymes that is injected into the affected area to break up the tough tissue. The drug loosens the tissue. If the contracture is still present on the following day, your doctor will stretch your finger and try to straighten it.
Surgical incisions will vary based on the extent of your Dupuytren's contracture but may look like a zig-zag on the palmar surface of the finger and hand. Dupuytren's contracture release can be painful. You will receive a prescription for narcotic pain medicine.
Key points to rememberSurgery can improve, but may not completely restore, the use of your hands. Dupuytren's disease comes back after surgery about half the time. You may need another surgery to keep the use of your hands. There are other nonsurgical treatments for Dupuytren's.
Is Dupuytren's contracture a disability? Dupuytren's contracture can result in a functional disability if it's severe and affects a person's range of motion and fine motor skills. Fortunately, it rarely affects the index and middle fingers, so writing ability stays intact.
The root cause of Dupuytren disease is unknown. Many, but not all patients appear to have a family or genetic predisposition. In some ways, it may resemble infection or cancer, but it is neither. The immune system is involved, but not exactly like an autoimmune disease.
XIAFLEX® is the only FDA-approved treatment for Dupuytren's contracture that does not require surgery. A hand specialist will inject this enzyme treatment directly into the cord that's causing limited mobility in the finger. The enzyme releases the cord.
At this stage, the hard lumps in the palm are called nodules. They may go away on their own in a small number of patients, but they usually progress. They can stay for months or years before anything else happens, says Eaton.
In stenosing tenosynovitis (i.e trigger finger), inflammation leads to trapping of the flexor tendon, while in Dupuytren's contracture pathologic proliferation and thickening of the palmar fascia leads to soft tissue contractures. Most commonly each diagnosis exists as a single form of pathology.
Dupuytren contracture occurs in about 5 percent of people in the United States. The condition is 3 to 10 times more common in people of European descent than in those of non-European descent.
Massage therapy may delay the progression of contractures and decrease recurrence in post-operative patients. Massage therapy treatment for Dupuytren's disease should not be vigorous and stretching should be a gentle exploration of range of motion.
Why is Dupuytren's contracture called Viking disease? Dupuytren's disease has been given the moniker “the Viking disease” due to its prevalence in the north of Europe and those of Northern European descent.
What's the explanation? One hypothesis is that pain and itching are due to immune-related pathways, consistent with a growing body of information that specific immune abnormalities and fibrocytes play a role in some Dupuytren patients.
Dupuytren's disease can affect any finger on the hand, but it most often appears in the ring finger. It can affect one or both hands. There may be no pain associated with the hardening of the tissue, but sometimes the tissue can swell and cause joint pain, burning, or itching.
Dupuytren's contracture most commonly affects the ring and pinky fingers, but all your fingers could be involved. One common finger flexibility exercise is to put your hand down flat on a table and practice spreading all your fingers as far apart as you can and then bringing them back together.
When both diseases coexist, the presence of rheumatoid hand deformities, especially flexion and ulnar deviation of the metacarpophalangeal joints, may mask the flexion deformity caused by Dupuytren's contracture.
Calluses are the most common cause of hardened skin on the fingers. They're a common reaction to repeated injury or friction. Callus symptoms include: dryness.
The most common sources of spasms include overused muscles and dehydration. Prolonged writing or typing can lead to hand cramping from overuse of the muscles. Other reasons for cramping are low levels of calcium and magnesium. Numerous things can affect your calcium level, but the usual culprit is vitamin D deficiency.
The bent finger usually functions fine and doesn't hurt, but its appearance can make some children self-conscious. Clinodactyly is uncommon, affecting about 3 percent of babies born in the general population. Any finger on either hand can be curved due to clinodactyly.
If you relax your hand, for example, you will see that the fingers do not lie flat; they naturally curl about halfway in. Although still alive, that half-curled shape approximates the position of flexion for the human hand.
