Dupuytren’s Contracture

What is Dupuytrens Contracture?

Dupuytrens Contracture is a common condition. It classically presents itself as a contracture of the finger, usually in the ring and/or little finger. It affects more men than women and generally occurs when people are in their 50s or 60s.

What is the cause ?

The exact cause is not known but it is related to your genes and can sometimes be seen in your family history.

What are the symptoms?

The first evidence of the condition is usually in the appearance of a nodule in the palm of the hand near to the base of the affected finger(s). This may progress to become a fibrous band running from the finger to the palm. This gradually draws the finger down into a bent position until it is no longer possible to keep the finger straight.
It is important to be aware that.

  • Dupuytrens Contracture is not malignant
  • It does not involve the tendons
  • It is rarely painful
  • The problem can return even after surgery but continued therapy will help to alleviate the symptoms.
  • If you are prone to developing dupuytrens condition then any injury may accelerate the onset.
  • Surgery can help to restore hand function but it will not cure the condition

What is the treatment?

Surgery involves a zigzag incision being made in the palm and/or finger(s) so that the affected tissue can be removed. If your finger has been contracted for a long period then it may not be possible for your surgeon to restore your finger to a fully straight position.

After surgery you will be fitted with a moulded night splint. You will be required to wear this each night for at least 24 months. Your physiotherapist will advise you if your splint becomes uncomfortable and they will also give you guidance on washing and careful for your splint.

Aftercare

Following surgery it is essential that you attend regular outpatient hand therapy treatment. This will involve physiotherapy that will help to improve/restore maximum hand function. Your physiotherapist will give you a few simple exercises to do and will teach you how to massage your scar.

It is important that you keep your hand elevated following surgery to help prevent any complications due to excess swelling.

Your wound will be monitored after surgery and your dressings will be changed between physiotherapy sessions to encourage your wound to heal and to prevent any infections.

It is important that you bring your splint with you to each appointment after surgery. This is because it may be necessary to alter your splint as your hand gets better.

Good nutrition helps wounds to heal so it is important that you eat a balanced diet. Whilst your hand is out of action it may be advisable to seek some help to prepare meals.

Smoking slows down healing. This is because smoking causes the blood vessels to constrict and reduces blood flow and oxygen. These are both essential to aid the healing process. It is important that you stop or cut down smoking for 3 weeks before and after surgery.

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