Dupuytren’s is a condition that can cause flexion contractures in the fingers and thumb of the hands. Most often the little and ring fingers are affected. It starts with a lump or pit in the palm, as pictured below. The severity and the speed the contractures develop varies. It is often called the ‘Vikings disease’ as it is very prevalent in northern Europe amongst the Scandinavian countries.
Symptoms The features include:
- A firm pit, lump or nodule appears on the palm, as pictured.
- A thickened cord grows from the palm into the fingers.
- The fingers are pulled towards the palm.
- Unable to lay hand flat on the table.
- The skin of the palm is dimpled and puckered.
- Mostly this condition is pain free.
- Functional impairment from contracted fingers.
Dupuytren’s Treatment options
Treatment options depend on the stage of the contracture.
Early stages
Pit or lump in palm but minimal contracture
- Corticosteroid injections into the tightened fascia tissues
- Low level radiation therapy – link below for locations and contact details – POW Hospital, NSW. http://www.dupuytren-online.info/radiotherapy_clinics.html
Severe contracture
Fingers are flexed and cannot be straightened.
- Enzyme (collagenase) injections
- Cutting the fascia bands through incisions in the skin.
- Fasiectomy – surgical removal of the fascia.
Hand Therapy
Hand therapy is required after the surgical removal of the fascia tissue and may involve:
- Wound care
- Splinting overnight
- Exercises to regain movement and strength
- Scar care – to soften surgical scars