Dupuytren Contracture (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- Dupuytren's contracture facts
- What is a Dupuytren's contracture?
- How fast does a Dupuytren's contracture develop?
- What are the causes and risk factors of a Dupuytren's contracture?
- What are the symptoms and signs of a Dupuytren's contracture?
- Is a Dupuytren's contracture limited to the hands?
- How is a Dupuytren's contracture diagnosed?
- What is the treatment for a Dupuytren's contracture?
- What are complications of Dupuytren's contractures?
- Can a Dupuytren's contracture be prevented?
- What is the prognosis (outlook) for Dupuytren's contracture?
- Find a local Orthopedic Surgeon in your town
What is the treatment for a Dupuytren's contracture?
The treatment of a Dupuytren's contracture depends on the severity and the underlying condition of the affected individual.
Most patients with a Dupuytren's contracture require reassurance and stretching exercises with heat application. When the palm is persistently sore with grasping, ultrasound treatments can be helpful. Sometimes local inflammation is best relieved with cortisone injection.
For patients with significant fixed flexed posture (contracture) of the fingers from a Dupuytren's contracture, when nonsurgical treatments have failed, surgical procedures can remove the scarred tissue to free the fingers and release the tendons. These procedures can return function to a disabled hand. Minor nodule formation and/or skin thickening of the palm is not a reason to operate. Sometimes the surgeon can release the scarred tissue by carefully cutting it with a needle. This procedure is referred to as a needle aponeurotomy or needle fasciotomy.
A newer treatment for a Dupuytren's contracture is collagenase (Xiaflex) injection. The scar tissue that forms the contracture is composed of a protein network called collagen. Collagenase is an enzyme that breaks up the collagen, which can then loosen the contracted tissue to restore finger mobility. Collagenase is directly injected into the contracted "cord" of scar tissue that causes the Dupuytren's contracture.
What are complications of Dupuytren's contractures?
The main complication of Dupuytren's contractures is loss of extension of the involved fingers. As a result, grasping certain objects can be limited. Occasionally, the flexed finger(s) can get in the way when using the hand, such as in dressing, etc.
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