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Treatment Options for Patients With Dupuytren Disease

Genetic condition causes fingers to curl and contract

Though you may not know it by name, you might have seen someone with the hand condition Dupuytren disease (or Dupuytren contracture). The telltale sign is a severely curled and contracted finger, typically the ring or pinkie finger, or both. It affects the ability to hold and grip objects, shake hands or simply put your hands in a pocket, and is often confused with arthritis.
Hand specialist Daniel Torres, MD, with LVPG Orthopedics and Sports Medicine, says patients with Dupuytren disease have treatment options once it progresses.

Dupuytren described

What causes Dupuytren?

Myoblast cells deposit collagen in the palm of the hand, initially creating nodules.

What happens next?

In some cases, nodules mature and become fibrous cords that cause the ring and/or pinkie fingers to contract.

Who is affected?

Most often men in their 50s and 60s, typically of northern European descent, but Dupuytren can affect anyone.

When is treatment needed?

Only after nodules have become fibrous cords.

Home self-test:

If you can lay the palm of your hand flat on a table, no treatment is necessary. Repeat the tabletop test at home every three to four months to check for progression of the disease. If you fail the tabletop test, ask your primary care provider to refer you to a hand specialist.

Dupuytren options

Torres says you have options if you fail the tabletop test and have your diagnosis confirmed by a hand specialist:

Collagenase injection:

an enzyme that dissolves the collagen in the cords.

Needle aponeurotomy:

a minimally invasive procedure in which a patient’s hand cords are ruptured by a hypodermic needle.

Surgery, including fasciotomy:

involves surgically cutting a patient’s hand cords and fasciectomy, the surgical removal of scar tissue in the palm.

The goal is for patients to be able to straighten their fingers, to put on gloves or put their hands in their pockets again. However, realistic expectations are critical. “No matter what we do, the disease recurs about 10 to 15 percent per year after any treatment,” Torres says.