Here we look at the causes, treatment options and aftercare of Dupuytren’s Disease
Dupuytren’s disease is a common but little-known condition that affects the hands of up to two million people in the UK. Also known as Dupuytren’s Contracture, Dupuytren’s disease is a condition that can cause one or more fingers to become bent in a flexed position, bending towards the palm.
While the condition can often be mild and painless, it can be a considerable inconvenience. Starting with small nodules under the skin in the palm of your hand, worsening over time until you eventually lose all practical function of the affected finger and can no longer straighten it fully.
Mr Kunal Hinduja, Lead Hand & Wrist Orthopaedic Consultant, “Unfortunately, for all advances in medicine and treatment, sadly there is no cure for Dupuytren’s disease. However, my team at Manchester Hand Surgeons can provide you with a range of treatment options suitable to the severity of your condition.”
Causes of Dupuytren’s Disease
Dupuytren’s disease is found more in males than females by a factor of around seven to one, to be precise. It’s also most likely to affect males over 40 years of age.
For all, it is difficult to pinpoint the exact cause of Dupuytren’s disease and some causes can link to:
- Family history
- Excessive alcohol consumption
- Having diabetes or epilepsy
How do you know if you have Dupuytren’s Disease?
Dupuytren’s disease may start with lumps, dimples or ridges on the palm of your hand. In such cases, you may find that you’re unable to put your hand down flat, and you struggle to carry out regular everyday activities. The disease occurs when the layer of connective tissue (under the skin of the palm) becomes thicker and less flexible, causing small nodules to form. These nodules can make it extremely difficult for your fingers to straighten, and over time the condition can worsen where the fingers will become permanently bent towards the palm. Dupuytren’s disease mainly affects the ring and little fingers and can occur in both hands at the same time. You may notice some changes to the palm of your hand too, which can indicate Dupuytren’s disease, including visible lumps or dimples. Nodules can be tender in the beginning; however, the condition usually causes patients no immediate discomfort, just inconvenience.
Unfortunately, treatment can’t always help in the early stages of Dupuytren’s disease; however, at Manchester Hand Surgeons, we will discuss all surgical options with you depending on the severity of your case.
Treatment does depend on the severity of your condition. Here at Manchester Hand Surgeons, we offer patients a range of different treatments, which we’ll discuss and go through with you in detail at your initial consultation.
If Dupuytren’s disease is diagnosed at an early stage and before the fingers become too bent, a night splint can be worn to treat the condition effectively. With these cases, we will offer patients a specially prescribed splint that helps straighten the fingers when the hand is resting and not in use.
Needle fasciotomy involves a needle which the surgical team will insert into different places along your palm and affected fingers to help loosen and straighten them. This procedure will include numbing the hand; however, it is a day procedure, and you will be able to leave the clinic on the same day. There is a two-week recovery period with this type of treatment. And again, with this kind of surgery, we often find that disease is likely to return. Risks with this treatment can include the incision reopening, the wound and hand can be tender for a few days after surgery, and numbness can occur.
At Manchester Hand Surgeons, our specialists can carry out a form of surgery known as fasciectomy to help straighten the affected fingers. Surgery will include making an incision along the palm of your hand and finger with the tight bands and nodules being carefully removed, and if necessary, the skin grafted over the palm. A day procedure with The Manchester Hand Surgeons, you can opt for this procedure to be carried out under general or local anaesthetic
Recovery time is between 4 – 12 weeks, depending on the severity of the finger condition. In most cases that we experience, surgery is the best form of treatment and the most effective and accurate in preventing the disease from returning. Risks with surgery can include bleeding, numbness, and a chance of infection.
Post-surgery we will recommend that the hand is elevated for several days as much as possible, and we will remove all stitches within two weeks. We will also provide a night splint, which we recommend wearing for between 3-6 months following surgery.
Pain and stiffness are not uncommon, and some patients may experience bruising and swelling for two to three weeks after treatment. This is completely normal, and our team will talk through all of this with you as well as some at-home treatments which can help reduce swelling and bruising.
We will advise hand exercises and provide physiotherapy and occupational therapy treatment for up to six months and will give more detail in all follow appointments and within our aftercare consultations.
You will be able to use your hand after a few days. Resuming light duties at work after 1-2 weeks and 3-4 weeks before returning to full activity (this will again be dependent on your specific job role, and your consultant can discuss this with you further during your appointments).
Regarding driving, we would recommend getting back behind the wheel when it is safe to do so, and after surgery and the possibility of a skin graft, this is typically after three weeks.
Book your initial consultation with Manchester Hand Surgeons today, and let us help you on the road to recovery.
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