Injury Articles

Dupuytren’s Disease

By November 14, 2019 No Comments

What is it?

Dupuytren’s Disease (or Dupuytren’s Contracture) causes a contracture of the hand that typically progresses slowly, over several years. It affects the fascia, a layer of tissue that lies under the skin of the palm.

The contracture begins as a thickening of the skin and as it progresses, the skin in the palm may appear puckered and dimpled. A firm lump of tissue can form in the palm.

In the early stages of Dupuytren’s, cords of tissue form under the skin and can extend up into the fingers. As the cords tighten, the fingers are pulled towards the palm.

The ring and the little fingers are most commonly affected, though the middle finger can be involved. Only rarely are the thumb and the index finger affected.

Causes

The cause of Dupuytren’s is unknown. There is no evidence that hand injuries or occupations that involve vibration to the hand contribute to the condition.

What to do?

  • Conservative interventions (non-surgical) demonstrate only limited short term improvements
  • An injection called XIAFLEX (collagenase clostridium histolytic) is a non-surgical option for patients with a palm cord.
  • Surgical intervention involves a fasciectomy to remove the diseased fascia. The skin can be closed with a graft in cases of significant dissection, left open to heal or sutured closed.

Hand therapy

Following medical interventions a period of hand therapy may be required to:

  • Restore range of movement.
  • Fabricate a night extension splint to prevent scar tissue pulling the finger into the palm
  • Manage scar healing with silicone tape and massage to soften and flatten the scar.
  • Restore optimal hand function