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DUPUYTREN'S DISEASE

Dupuytren’s disease (also referred to as dupuytren's contracture) is a common condition that usually arises in middle age or later and is more common in men than women

Dupuytren's disease

Dupuytren’s disease (also referred to as Dupuytren's contracture) is a common condition that usually arises in middle age or later and is more common in men than women. Firm nodules appear in the ligaments just beneath the skin of the palm of the hand, and in some cases they extend to form cords that can prevent the finger straightening completely. 

The nodules and cords may be associated with small pits in the skin. Nodules over the back of the finger knuckles (Garrod's knuckle pads) and lumps on the soles of the feet are seen in some people with Dupuytren's disease.

Why does it occur?

Why does it occur?

The cause is unknown, but it is more common in Northern Europe than elsewhere and it often runs in families. Dupuytren's disease may be associated with diabetes, smoking and high alcohol consumption, but many affected people have none of these. It does not appear to be associated with manual work. It occasionally appears after injury to the hand or wrist, or after surgery to these areas.

Symptoms

Symptoms

Dupuytren's disease begins with nodules in the palm, often in line with the ring finger. The nodules are sometimes uncomfortable on pressure in the early stages, but the discomfort almost always improves over time. In about one affected person out of every three, the nodules extend to form cords that pull the finger towards the palm and prevent it straightening fully. Without treatment, one or more fingers may become fixed in a bent position. The web between thumb and index finger is sometimes narrowed. Contracture of fingers is usually slow, occurring over months and years rather than weeks.

Treatment

Treatment

There is no cure. Surgery can usually make bent fingers straighter, though not always fully straight; it cannot eradicate the disease. Over the longer term, Dupuytren's disease may reappear in operated digits or in previously uninvolved areas of the hand. But most patients who require surgery need only one operation during their lifetime. Published evidence does not support the use of radiotherapy.  Injection of collagenase is helpful in some cases. 

Surgery is not needed if fingers can be straightened fully. It is likely to be helpful when it has become impossible to put the hand flat on a table, and should be discussed with a surgeon at this stage. The surgeon can advise on the type of operation best suited to the individual, and on its timing. The procedure maybe carried out under local, regional (injection of local anaesthetic at the shoulder) or general anaesthetic.

Surgical options are:

  • Fasciotomy. The contracted cord of Dupuytren’s disease is simply cut in the palm, in the finger or in both, using a small knife or a needle.
  • Segmental fasciectomy. Short segments of the cord are removed through one or more small incisions.
  • Regional fasciectomy. Through a single longer incision, the entire cord is removed.
  • Dermofasciectomy. The cord is removed together with the overlying skin and the skin is replaced with a graft taken usually from the upper arm. This procedure is usually undertaken for recurrent disease, or for extensive disease in a younger individual and helps prevent recurrence.

After surgery, the hand may be fitted with a splint to be worn at night. Hand therapy is important in recovering movement and function, especially for more extensive surgery and skin grafts. The recovery is variable with regard to the degree of improvement achieved and the time to achieve the final position.  The final outcome is dependent on many factors including the extent and behaviour of the disease itself and the type of surgery required.

Consultations & Clinic Info

Consultations, Clinics, Directions and Accommodation

Live outside Hull & East Yorkshire? Here's some useful information if you need to travel and stay over as part of your surgical procedure to fix Dupuytren's disease.

Mr Riaz's patient support team will arrange with you which of the three main (Hull, Grimsby & Doncaster) clinics your consultation and cosmetic surgery procedure will take place. We have detailed below useful information for each of the locations, which will assist you during your cosmetic surgery journey.

Mr Riaz's Patient Support team can be contacted during office hours on 01482 841228 & 01482 841229.


Spire Hospital

Lowfield Road
Anlaby
Hull & East Riding
HU10 7AZ
01482 841228

Useful Info
About Spire Hospital
Traveling directions by Car or Train
Local Accommodation

St Hugh's Hospital

St Hugh's Hospital
Peaks Lane
Grimsby
DN32 9RP
01472 898725

Useful Info
About St Hugh's Hospital
Traveling directions by Car or Train
Local Accommodation

Park Hill Hospital

Thorne Road
Doncaster
South Yorkshire
DN2 5TH
01302 553355

Useful Info
About Park Hill Hospital
Traveling directions by Car or Train
Local Accommodation

 

Related Hand Procedures

CARPAL TUNNEL SYNDROME (CTS)

Carpal tunnel syndrome (cts) is a common condition that causes a tingling sensation, numbness, and sometimes pain in the hand and fingers.

CUBITAL TUNNEL SYNDROME

Cubital tunnel syndrome is compression or irritation of the ulnar nerve in a tunnel on the inside of the elbow (where your 'funny bone' is).

GANGLION CYSTS

Ganglion (mucous) cysts are the commonest type of swelling in the hand and wrist.

TRIGGER FINGER / THUMB

Trigger finger is a painful condition in which a finger or thumb clicks or locks as it is bent towards the palm.


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