Understanding Dupuytren's Contracture
Tests for Dupuytren's Contracture
Your doctor should be able to tell that you have Dupuytren's contracture just by looking at your bent fingers and feeling the tissue on your palm. The doctor might also check the strength and range of motion in your affected hand.
One test that can help diagnose the condition and determine whether you need surgery is the "table top" test. During this test, place your hand, palm side down, on a table. If the hand does not lie flat, the symptoms of Dupuytren's contracture are probably significant enough that you need to have surgery.
Dupuytren's Contracture Treatment
If Dupuytren's contracture isn't bothering you much, you shouldn't need treatment. However, if Dupuytren's is interfering with your daily activities, your doctor may recommend one of these treatments:
Stretching exercises for very mild cases
Steroid injections to help bring down inflammation and possibly slow the course of the disease (they don't actually straighten the finger.)
If your fingers are already bent, collagenase (Xiaflex), a mixture of enzymes that help dissolve the tough tissue, may be injected into the affected area by your doctor. This weakens the tight bands and may allow your doctor to then stretch the tightened area and straighten your finger. 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.
When surgery is called for, the surgeon performs a fasciotomy in which tissue from the palm is removed through an incision. Then the open wound is allowed to heal on its own, or it is covered with a skin graft taken from another part of your body. The hand is often splinted after surgery to help with healing.
Surgery for Dupuytren's can have risks, including:
- Damage to nerves and blood vessels in the affected fingers
- Permanent stiffness in the fingers