According to the American Society for Surgery of the Hand (ASSH), Dupuytren’s contracture occurs when the hand tissue beneath the skin becomes diseased and thickens, forming nodules. These nodules grab onto the skin above it and tether to it, creating pits from the skin pulling inward.
Dupuytren’s contracture also can develop cords in the palm that may extend to the fingers. As the disease progresses, these cords can thicken and shorten causing the fingers or thumb to contract toward the palm.
Symptoms of Dupuytren’s contracture include:
- Nodules (rarely painful or tender)
- Pits
- Cords which can cause finger/thumb contractures
- Thickened knuckle pads on the backside (dorsum) of hands
Physicians don’t know why Dupuytren’s contracture happens to some patients, but it tends to occur more in men than women and also in patients over the age of 40. It is sometimes referred to as “Vikings Disease,” as it runs in families with a northern European ancestry link.
Treatment Options for Dupuytren’s Contracture
Treatment options for Dupuytren’s contracture include surgery (either open or with a needle) or an injectable medicine called Xiaflex®. This FDA-approved medicine has been on the orthopedic scene for a little over four years and has given some patients a viable non-surgical option.
If you or your physician suspect that you have Dupuytren’s contracture, it’s important to consult with a hand surgeon. St. Elizabeth Healthcare and OrthoCincy Orthopaedics & Sports Medicine offers skilled Hand Surgeons in the Tri-state area.
Dr. James Baker, a board-certified hand surgeon specializing in the treatment of hand, wrist and elbow disorders, treats patients with Dupuytren’s contracture and can treat them in-office with Xiaflex® injections.
“Xiaflex is a great option for some of our Dupuytren’s contracture patients who aren’t yet ready for surgery,” says Dr. Baker. “In the right patient, the results can be magic – the contracture is corrected and they’re back to normal use in two weeks.”
Typically, the physician injects Xiaflex® into the patient’s affected cord area. A finger extension procedure is then scheduled 24-72 hours later with the physician. Anesthesia typically is not used during the Xiaflex® injection but will be used during the finger extension procedure.
Xiaflex® benefits include a faster recovery and less expensive than undergoing surgery. However, compared with surgery Xiaflex® patients have a higher rate of Dupuytren’s contracture reoccurring. The good news is that repeating the injection in the future is often possible.
The surgical option excises most of the diseased tissue so it takes longer to grow back; however, patients undergoing surgery do have a longer recovery and require significant hand therapy after surgery.
Schedule an Appointment Today
If you are interested in learning more about Dupuytren’s contracture, Xiaflex® or hand surgery options with St. Elizabeth and our affiliated orthopaedic surgeons, please call OrthoCincy Orthopaedics & Sports Medicine at (859) 301-2663 for more information.
