Treatment Options for Dupuytren’s Contracture
Nonsurgical Treatment for Dupuytren's Contracture continued...
Most people need one or two injections in the affected joint, but some people may need up to three injections to straighten or nearly straighten the finger. The most common side effects are swelling in the affected area or bleeding, bruising, and pain at the injection site. Rarely, more serious side effects, such as damage to a tendon, nerve injury, or allergic reaction may occur.
Splinting, vitamin E cream, and ultrasound are some of the other treatments that have been tried but generally have not been successful.
Surgery for Dupuytren's Contracture
What if it becomes difficult for you to grasp objects or perform other daily activities? Your health care provider may recommend surgery if your disease progresses. The goal of surgery is to restore motion in your fingers.
The surgeon makes an incision and either divides (fasciotomy) or removes (fasciectomy) part or all of the thickened bands of tissue.
A variety of techniques are used to close the wound. Sometimes a skin graft is needed for the incision to completely heal. To do this, the surgeon takes healthy skin from another area of the body and attaches it to the area in the hand that needs to be closed.
An alternative to open surgery is an office procedure called needle aponeurotomy. The surgeon uses a hypodermic needle to divide and cut the diseased tissue in the palm and fingers.
This procedure is less invasive and leads to a quicker recovery than open surgery. Many do not need rehabilitation with physical therapy following the procedure. A presurgical evaluation can determine whether you are a candidate for this procedure.
What to Expect After Surgery
Surgery may be able to correct the changes of Dupuytren’s if only one of the knuckles connecting the finger to the hand is involved.
If two or more fingers are involved in this joint, it is more difficult to correct the contraction. For other joints of the fingers, surgery may improve but not correct the limitations caused by this disease.
Both open surgery and needle aponeurotomy have a high rate of recurrence of contractures. Also, open surgery can lead to an exaggerated reaction to the wound.