1. What is Dupuytren's contracture?
Dupuytren's contracture is painless fibrous tissue formation under the skin on the palm of the hand and at the base of the fingers. The condition begins as lumps of painless tissue that are often mistaken for callouses. Over time thick bands of tissue can form, pulling the fingers down toward the palm.
2. Why does Dupuytren's contracture develop?
The condition is hereditary but occasionally develops in individuals without any family history. Dupuytren's contracture is seen most often in people of Northern European and Scandinavian ancestry. It is not associated with occupation and does not result from trauma. Its prevalence is approximately 10 times more frequent in men than in women.
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3. I have heard that Dupuytren's contracture occurs most often in the dominant hand. Is this true?
No.
4. If I have Dupuytren's contracture in one hand, will the other hand be affected?
It is likely, particularly if there is a family history of Dupuytren's.
5. How is Dupuytren's contracture diagnosed?
In its advanced stages, Dupuytren's contracture is quickly assessed and diagnosed by a physician. In its earlier bumpy phase, it is frequently confused with callouses.
6. How is Dupuytren's contracture treated?
Surgery used to be the only method to treat the contractures, but now there is a new technique that avoids the risks of surgery and shortens rehabilitation time. A specialized enzyme that will dissolve in one to three days (XIAFLEX) is precisely placed into the hand by a trained specialist during an office visit. During a second visit a few days later, the finger is numbed and straightened. For the majority of patients, this manipulation will result in a near full correction. Specially-trained hand therapists will then make a splint to help keep the fingers straight and the patient will start a self-supervised course of therapeutic exercises.
Virginia Mason's board-certified hand surgeons have been specially trained and have extensive experience in safety and effectively administering XIAFLEX.
7. Can the condition return after injection or surgery?
The injection only removes the tissue causing the contracture. The diseased tissue on either side of that location remains. Early studies show that injections done in the palm result in a recurrence rate of 50 percent at three years. Injections into fingers have a 62 percent recurrence rate. The good news is that many of the recurrences can be re-injected. Surgery has a 50 percent recurrence rate at five years.
8. Where does the name "Dupuytren's contracture" come from?
Dupuytren's contracture is named after a French surgeon, Baron Guillaume Dupuytren (1777-1835) who put his name on the condition. The name is pronounced do-pee-truns.
9. When should I see a hand surgeon about Dupuytren's disease?
If you cannot put your hand flat on a table top, it is time to see a hand surgeon. The standard recommendation is to consider surgery when the contractures approach 30 degrees, since that is when the disease starts to interfere with hand function.
For more information about treatment for Dupuytren's contracture, contact Virginia Mason's hand surgery team at (206) 341-3000.