Dupuytren’s contracture is a deformity of the hand which develops over years. The layer of tissue lying underneath the skin of your palm gets affected. Knots of tissue form beneath the skin and in due course a thick cord is formed which pulls your fingers into a bent position.
The fingers that have been affected cannot be straightened completely, and this can greatly complicate day to day activities.
The condition usually afflicts the little finger and the ring finger. There are a number of treatment options available to allay the symptoms as well as decelerate the progression of the contracture.
Symptoms Of Dupuytren’s Contracture
Dupuytren’s contracture progresses slowly, over several years. It commences as a thickening of the skin on the palm. The skin appears dimpled or puckered. A knot of tissue may develop on the palm. The lump may be sensitive or painful.
Gradually, cords of tissue form under the skin and they extend to the fingers. As the cords tighten, the fingers get pulled towards your palm.
What Causes Dupuytren’s Contracture?
The exact cause for the occurrence of Dupuytren’s contracture is not known.
A few factors may increase your risk though and these are:
- Males are more susceptible to Dupuytren’s contracture and also tend to have more severe contractures than women.
- Dupuytren’s contracture is known to run in families.
- Smoking has been linked to an increased risk of developing Dupuytren’s contracture, conceivably due to the fact that there occur microscopic changes in the blood vessels due to smoking. Alcohol intake is another risk factor.
- Individuals having diabetes mellitus are reported to have a high risk of Dupuytren’s contracture.
Treatment Options For Dupuytren’s Contracture
If the condition is progressing slowly, and causes no discomfort and pain and has little impact on your ability to use your hands for daily activities, you may not require treatment. Wait and watch how the contracture progresses. Avoid having a firm grip on tools by putting pipe insulation or cushion tape on the handles; it helps. Use gloves that have a heavy padding when you need to perform heavy grasping tasks.
Treatment comprises of breaking apart or getting rid of the cords which pull the fingers towards the palm. The line of treatment depends upon the intensity of the symptoms and other health problems that you may have.
- Needling: Your doctor will insert a needle through your skin, to pierce and break the cords that are contracting the finger. Contractures are known to recur, so the procedure may need to be repeated. Physical therapy needs to be carried out after the procedure.
- Enzyme injections: Introducing an enzyme into the taut cord helps soften and weaken it and your doctor can then break the cord and straighten the fingers.
- Surgery: In case your condition is progressing fast and mobility is drastically restricted, you need to surgically get rid of the cords in your palm.
- In extreme cases, more so if surgical intervention has failed to remedy the problem, your surgeon will excise out all tissues that are likely to be afflicted by the contracture, including the attached skin. Skin grafting will also be required to cover the open wound.