Can Dupuytren’s Contracture Be Treated?

Dupuytren’s contracture causes fingers to curl toward the palm. Although there is no cure for this condition, there are a number of treatments to slow the progression of the disease.

According to historic lore, Dupuytren’s contracture was brought to Northern Europe by raiding Vikings. Although we can’t vouch for this swashbuckling version of the disease’s origin, we do know that instances of the condition were noted as early as the 12th and 13th centuries—hundreds of years before it was named in the 19th century—and that it is most common among patients of Northern European descent. It’s no surprise that we see our share of patients with Dupuytren’s here in Scandinavian-settled Minnesota.

Over time in most patients, Dupuytren’s contracture will slowly cause one or more fingers to curl down toward the palm. The condition is not dangerous, but it can become increasingly inconvenient over time. Currently, there is no cure for this disease, but we do have a number of treatments to improve finger function and slow the progression.

  • Steroid injections may help relieve pain. In some cases, injections have prevented the contracture from progressing.
  • Enzyme injections are a relatively new treatment that has been approved by the Federal Drug Administration. The enzyme is injected directly into the diseased tissue; over the course of several hours, the enzyme breaks down the tough tissues that cause the finger to contract, and allows the finger to straighten again. Early results are promising, but we don’t have enough data to know long-term recurrence rates after this treatment.
  • A needle aponeurotomy is another new, less invasive procedure used by some surgeons. The hand is numbed with a local anesthetic, and then a hypodermic needle is used to divide the diseased tissue. No incision is required, and patients recover with less pain and swelling compared to surgery. As with enzyme injections, we are still waiting for more information about the long-term recurrence rates of this newer procedure.
  • Open surgery can be used to divide or remove the thickened tissue in the palm in cases where the disease has progressed enough to impair function. Complications are rare, but sometimes skin grafts are needed, and there can be risks to nerves and blood vessels. Approximately 20 percent of surgical patients experience a degree of recurrence.

If you suspect that you may have inherited more than some colorful tales as part of your Viking ancestry—or if curled fingers make it difficult for you to lay your hand flat on a table, grasp objects, or slide your hand easily into a pocket, we’ll be happy to evaluate your hand and, if appropriate, talk about tailoring a treatment option to your needs.

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