Dupuytren's Contracture: Causes, Symptoms, and Treatment
How Is Dupuytren's Contracture Treated?
There is no cure for Dupuytren's contracture. However, the condition is not life threatening, and it may not cause a person discomfort for many years, if ever. Some patients never need treatment, just monitoring.
If the condition is painful or interferes with a person's daily activities, treatment may be helpful. Treatment includes medication and surgery.
It's important to note that finger splints do not help patients with Dupuytren's contracture and may even be harmful. Stretching the finger forcefully can actually speed up the inward curling of the finger.
Medication for Dupuytren's Contracture
If a nodule is extremely tender, your doctor may recommend a corticosteroid injection, also called a steroid shot. A corticosteroid is a powerful anti-inflammatory medicine, which reduces swelling and inflammation. It may help ease your pain and in some cases may prevent finger contractures from getting worse, but won't straighten your finger if you already have a contracture. You might need a series of shots to see long-term results.
If your fingers are already bent, Xiaflex, a mixture of enzymes that help dissolve the thick and tight 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. The most common side effects seen with Xiaflex are swelling, bleeding, bruising, or pain at the injection site. Rarely, tendon or ligament damage may occur that requires surgery to fix. Your doctor can help you determine if enzyme injections or surgery is right for you.
Surgery for Dupuytren's Contracture
If the condition continues to get worse despite medications and your hand function is severely limited, your doctor may recommend surgery.
Traditional surgery for Dupuytren's contracture involves cutting or removing the thick bands of tissue in the palm of the hand to help restore proper finger motion.
All surgery comes with risks. Complications of Dupuytren's contracture surgery are rare but may include:
- Injury to the nerves and blood vessels in the hand
- Permanent stiffness of the fingers
You will have some hand swelling and discomfort after the procedure. Raising your hand above your heart level and flexing your fingers can help relieve swelling, stiffness, and pain and speed up your recovery. Recovery can take several months.
Most patients can move their fingers better after traditional Dupuytren's contracture surgery. However, the condition returns in about one in five people who have had this surgery.
A less invasive procedure, called needle aponeurotomy, is an alternative to traditional surgery for Dupuytren's contracture. Instead of an open incision, it uses the sharp end of a needle to cut the thick bands under the skin, which may help you recover faster. However, it is not as effective in treating the more severe cases. As a whole there is less risk of complications, but there is a risk of nerve, blood vessel, or tendon damage. Needle aponeurotomy is even more effective when used in combination with corticosteroid injections. A specialized hand surgeon must perform this procedure. Ask your doctor what type of surgery is best for you.
Your doctor may recommend physical therapy after surgery.