Treatments

Diagnosis

See your family doctor if you think you have Dupuytren’s disease. The first step is to examine your palm and hand for signs of the condition.

Characteristic signs of Dupuytren’s disease are:

  • lumps of tissue (nodules)
  • dimples or pitted marks
  • thickened skin
  • bent fingers

 

Dupuytren’s disease affects everyone differently, so you’ll be asked about any specific symptoms you have and any problems with carrying out daily activities. Some people are troubled by quite a minor deformity, while others are able to cope with a major one.

 

If you’re unable to fully extend one of your fingers, your family doctor may refer you to a specialist of hand surgery unit for further assessment and any necessary treatment.

Assessing the need for treatment

If your finger is curling into your palm, the amount of deformity will be measured to determine the severity of the condition.

 

In mild cases, no treatment may be recommended in most cases because there’s a chance the condition won’t get any worse.  Radiation therapy is sometimes considered to stop or slow down the process if applied in early nodular stages.   If the condition is more severe, treatment with medication or a minor procedure called a needle fasciotomy may be recommended.

 

In the most severe cases, surgery to correct the problem may be recommended.

Dupuytren’s disease treatments’ overview

A complete description of the treatments is detailed in the following pages. If your family doctor is not familiar with the different treatments, you can bring this information to your appointment.

 

Many cases of Dupuytren’s contracture are mild and don’t need treatment. Treatment may be helpful if the condition is interfering with the normal functioning of your hand.

 

Non-surgical treatments include radiation therapy and injections with a medication called collagenase.

Alternatively, a minor procedure that involves using a needle to cut the contracted cord of tissue (needle fasciotomy) may be used in the early stages of the contracture condition.

 

In more severe cases, surgery can help to restore hand function. The two most common surgical techniques are:

  •  open fasciotomy– where the shortened connective tissue is cut to relieve tension
  •  fasciectomy– where the shortened connective tissue is removed

 

Surgery for Dupuytren’s contracture can’t always fully straighten the affected finger or thumb, and the contracture can recur after surgery. If a contracture does recur, further surgery may be possible.

 

Having surgery to remove the first nodule that appears won’t stop the condition from progressing, as this won’t stop the condition occurring elsewhere in the palm. It’s usually best to avoid surgery until a contracture develops that interferes with the use of the hand.

 

Dupuytren’s disease often runs in families and genetic research hopes to identify the genes responsible for the condition. This could lead to the development of treatments that prevent contractures occurring in the first place.