Dupuytren’s Contracture

What is Dupuytren’s contracture?

Dupuytren’s contracture is where one or more fingers bend in towards the palm. It is estimated that Dupuytren’s contracture affects approximately 4% of the general population in the UK, increasing to about 20% in people aged 65 years and over. The condition is more prevalent in men than women, in the UK more than 2 million people are thought to have Dupuytren’s disease.

The main pre-cursors of Dupuytren’s are:

Age – Dupuytren’s predominantly affects people over the age of 40 and severity increases with age
Family history – Dupuytren’s is an inheritable condition
Northern European Descent

Other risk factors to consider include:

Diabetes – studies have shown that the average prevalence of Dupuytren’s in patients who have diabetes was found to be approximately 31% and that people who have had diabetes for longer, were more likely to develop Dupuytren’s disease.
Smoking – the prevalence of Dupuytren’s disease has been reported to be up to three times higher in smokers.
Alcohol consumption – has been shown to have a positive association with the diagnosis of Dupuytren’s disease.
Epilepsy – there is some evidence of association between epilepsy and Dupuytren’s disease.

Diagnosis

The below are signs of possible Dupuytren’s disease, see your GP if you are concerned about any of the following:

Thickening and pitting of the skin on the palm
Firm nodules on the skin and palm
Cords (ligaments) present in the hands
Contraction of the knuckles and hand joints, most
Commonly affecting the fourth and fifth fingers

Eventually, you may not be able to bend your fingers. If you are in the early stages your doctor may ask you to perform a table top test. This is where you will lie your palm and fingers flat on a table top. If you are unable to do this, it is likely you have Dupuytren’s disease.

Surgical treatment

Whilst Dupuytren’s contracture cannot be cured, there are certain surgeries that may help to straighten your fingers if they are considerably bent. At North West Hand Clinic we will discuss the different types of procedures available and what is most suitable for your condition, and whether it will need to be performed under local or general anaesthetic.
Different types of surgical treatment include:

Needle fasciotomy

This is an outpatient procedure performed under local anaesthetic where a needle is used to release the tension in the joints.

Fasciotomy

This type of procedure is usually performed under general anaesthetic but can also be done under local anaesthetic. A cut is made along your palm to allow the surgeon to straighten it.

Dermofasciectomy

This can again be performed under general or local anaesthetic. The procedure is similar to the fasciotomy, however it is split into two. The first procedure is where your surgeon will remove an area of skin and straighten the fingers, then four days later they will add skin taken from a graft elsewhere in the body to replace the removed skin.

Recovery

In most cases you should be able to leave the hospital the same day as your procedure. Depending on your procedure, you can expect to make a full recovery anywhere between 2 and 12 weeks after surgery. Following surgery, you may find wearing a hand splint at night helpful with recovery. Hand therapy can also help to recover your movement and function, your surgeon will help to determine whether you need to see a hand therapist.

It’s important to note that these procedures cannot cure Dupuytren’s disease, but they can help to improve the function of your hand.

Whatever your hand or wrist condition is, we can help.

Mr Randeep Mohil provides clinics across Lancashire and Cheshire.

Please call us on 01625 466158 or email info@northwesthandsurgeon.co.uk

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Lancashire Clinics

The Beardwood Hospital, Blackburn
Clinic days: Monday evenings (alternate) and Thursday mornings
Website: The Beardwood Hospital
Ramsay Fulwood Hospital, Preston
Clinic days: Monday and Tuesday evenings (alternate)
Website: Ramsay Fulwood Hall

Ramsay Euxton Hall Hospital, Chorley Clinic days: Tuesday evenings (alternate) Website:Ramsay Euxton Hall

Cheshire Clinic, Northwich Clinic days: Friday morning (alternate) Website: The Cheshire Clinic

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Dupuytren’s Contracture

What is Dupuytren’s contracture?

Diagnosis

Surgical treatment

Needle fasciotomy

Fasciotomy

Dermofasciectomy

Recovery

Whatever your hand or wrist condition is, we can help.

Get in touch