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Dupuytrens Contracture

Dupuytrens Contracture

Dupuytren's contracture is a condition in which there is a thickening of the tissues in the palm and in the fingers and thumb. The thickened tissue forces several fingers - usually your ring and pinky fingers - to curl in toward your palm. The bending caused by the thick tissue is called contracture.

 Signs and symptoms of Dupuytrens Contracture may include

  • The first symptoms for many patients is one or more lumps (nodules) under the skin in the palm of the hand. The lump may feel tender and sore at first, but this discomfort eventually goes away.
  • The pinkie and ring fingers are most often affected, appearing clenched. Both hands are usually involved, although one may have worse symptoms than the other.
  • The thickening of the skin usually happens very slowly. You don't need treatment unless your symptoms bother you.

Some patients with Dupuytren's disease may develop thickened tissue on the feet (Ledderhose disease) or penis (Peyronie's disease). Symptoms do not occur anywhere else on the body.

Preparing For Your Dupuytrens Contracture Surgery

Before you have your surgery, there are a few preparation tips that we recommend. You shouldn't eat or drink anything after midnight the night before. It is important to follow your surgeon's pre and post-op advice as this is specific to you. We may ask for detailed descriptions of your symptoms and information about medical problems you've had in the past.

Post Operative Activities

  • Patients who have an external fixator applied for severe or recurrence contractures care shown how to care for the fixator both in terms of cleaning and maintaining mobility of the joints.
  • The second operation which involves a dermofasciectomy and a skin graft is usually scheduled four to six weeks following the application of the external fixator when the finger has been completely straightened.
  • Most patients have good return of function in their operative hand. After Dupuytren's surgery to straighten out your fingers, the toughest part is regaining finger flexion and the ability to make a tight fist.
  • Most patients have good grip at one month but recovery may take 1-3 months for full finger flexion and strong grip with the hand.

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Frequently Asked questions

Dupuytren's contracture can manifest in any of the following ways:
- A nodule in the palm or digits
- A pit in the skin of the palm or digits
- A cord in the palm or digits
- A extension of a cord from the palm into the fingers resulting in an inability to fully straighten the joints of the fingers or thumb.
In addition to an inability to straighten the fingers completely the nodules or cords of Dupuytren's contracture can occasionally be painful. The restriction of mobility and abnormal position of the fingers is socially inhibiting especially when shaking hands.
The treatment of Dupuytren's contracture depends upon the extent and severity of the problem.
Just like any other operation surgery for Dupuytren's contracture can have post operative problems such as bleeding, haematoma formation, infection or delayed healing of the wound.
Most patients will have fine stitches placed in the skin and the hand is placed in a plaster splint. The splint is removed in the week following surgery by the Hand Therapist who then prepare a plastic splint to keep the fingers and thumb stretched. This plastic splint is normally worn at night after the first two weeks and the hand is free during the day to exercise and to use for day to day activities. The plastic splint is normally for a period of six months following surgery.
Yes, but it most commonly affects the ring finger followed by the small finger.
The inability to open the fingers fully may make it difficult to grip and grasp objects such as tools, instruments, a golf club, and so forth. The fingers also may get jammed and injured easily as the person reaches out to grab an object or puts their hand in their pocket.

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