Dupuytren’s disease

Dupuytren’s disease is characterised by abnormal thickening of the fascia in the palm and/or fingers.

 

It usually starts with a small lumps (nodule) within the skin which then slowly progresses into the cord that pulls finger(s) towards the palm.  Contracture occurs when finger(s) cannot be fully extended (straightened).

Many cases of Dupuytren's disease are mild and do not need treatment.  Patient is offered treatment when contracture is interfering with the normal functioning of the hand. Surgery can straighten the fingers, but cannot eradicate the underlying disease. Monitoring is advisable.

  • Non-surgical treatments include radiation therapy and injections with a medication called collagenase.
  • Surgical interventions range from relatively minor (simple division of the contracting cord) to extensive resections of diseased tissues and straightening of bent finger(s). Operations are tailored to individual needs and are generally very successful in trained hands.

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Early disease palm and finger fascia affected with Dupuytren’s disease (cords and nodules).

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Advanced Disease of the palm and little finger fascia.

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Isolated finger only disease.

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Degree of finger deformity before operation.

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Improvement achieved by surgery with use of skin graft at the base of little finger.

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Patient with Dupuytren’s contracture of the ring fingers in both hands right hand was operated 6 months previously; right finger has been straightened so much that skin graft was needed to resurface the skin shortage created by digit straightening; Patient is now awaiting surgery for the left ring finger.

Picture illustrates nicely marked improvement in finger position which can be achieved surgically.