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Dupuytren’s Contracture Treatment Pune
Get specialized Dupuytren’s contracture treatment in Pune with hand surgeons providing surgical correction and physiotherapy.
Overview
Dupuytren’s contracture is a medical condition that affects the hands, causing curved fingers and limiting hand movement. This condition occurs when the tissue layer beneath the skin in your palms and fingers becomes abnormally thick and tight. This tissue, called the palmar fascia, normally helps support your hand structure.
When you have Dupuytren’s contracture, small, firm bumps called nodules develop in this tissue. Over time, these nodules can form thick cords under your skin, pulling one or more fingers toward your palm. This creates a hand contracture that makes it difficult or impossible to straighten your affected fingers completely.
Symptoms
Dupuytren’s contracture symptoms usually develop gradually and may include:
The earliest signs often appear as lumps, dimples, or ridges on your palm. You might notice a small nodule near the base of your fingers, which may or may not be painful initially. Any early soreness typically goes away with time.
As the condition progresses, these nodules grow and extend into hard cords under your skin that reach into your fingers. These cords become thicker and shorter, causing your fingers to bend toward your palm in a fixed position. This finger bending problem most commonly affects the ring finger and little finger.
Key symptoms include:
- Small lumps or nodules in the palm
- Thick cords of tissue under the skin
- Finger curls that cannot be straightened
- Loss of hand movement and flexibility
- Difficulty placing your hand flat on surfaces
The condition frequently affects both hands, though one may be more severe than the other. While pain isn’t usually a main symptom, the hand contracture can significantly impact your daily activities. In rare cases, nodules may become tender if they press on nerves.
Causes
The exact cause of Dupuytren’s contracture remains unknown. However, research shows that genetic factors play an important role in who develops this condition. Scientists believe it’s likely a combination of genetic predisposition and other factors that trigger the development of the thick, contracted tissue.
Risk Factors
Several factors can increase your likelihood of developing Dupuytren’s contracture:
Age and Gender: The condition most commonly appears after age 50, and men are significantly more likely to develop it than women. Men also tend to experience more severe symptoms that progress faster.
Family History: Dupuytren’s contracture often runs in families, making genetics a strong risk factor. If family members have had this condition, your risk increases.
Health Conditions: Having diabetes increases your risk of developing Dupuytren’s contracture.
Lifestyle Factors: Both smoking tobacco and drinking alcohol are known to increase risk.
Diagnosis
Diagnosing Dupuytren’s contracture primarily involves a thorough physical examination of your hand. Your healthcare provider will:
- Examine your palm and fingers for characteristic nodules and cords
- Measure the range of motion in your fingers and thumb
- Test your ability to lay your hand flat on a surface (tabletop test)
- Record the location and severity of contractures
No specific blood tests are needed to diagnose Dupuytren’s contracture. However, your doctor might order tests to rule out other conditions like arthritis or diabetes that could affect your hands. Ultrasound can sometimes help visualize the thickened tissue.
It’s important to distinguish Dupuytren’s contracture from other hand conditions that might cause similar symptoms, such as ganglion cysts, calluses, or trigger finger.
Stages
Dupuytren’s contracture is classified into stages based on severity and impact on hand function:
Mild Stage: You may have little to no hand contracture (less than 30 degrees at the main knuckle joint). There are usually no functional problems, and observation is typically recommended rather than active treatment.
Moderate Stage: This stage involves functional problems that interfere with daily activities. You might have moderate contracture (30-60 degrees at the main knuckle joint or more than 30 degrees at the middle finger joint). Treatment options like needle procedures may be considered.
Severe Stage: Significant functional impairment occurs with severe contractures affecting multiple joints. Surgical interventions are typically recommended at this stage.
Treatment decisions are based on how much the condition impacts your quality of life. Many doctors recommend treatment when you can no longer lay your palm flat on a table or when contractures reach certain degrees.
Treatment
Treatment for Dupuytren’s contracture depends on how severe your finger bending problem is and how much it affects your daily life. Since the condition progresses slowly, you might not need treatment immediately.
Conservative Management: For stable, painless conditions that don’t impair function, observation is appropriate. Early-stage treatments may include:
- Physical and occupational therapy
- Splinting to help stretch fingers
- Maintaining hand range of motion
- Corticosteroid injections for painful nodules (though results vary)
Needle Fasciotomy: This less invasive procedure is often chosen for mild hand contracture, especially affecting the main knuckle joints. A small needle breaks up the thickened cord, allowing immediate finger straightening. While minimally invasive, it has high recurrence rates.
Collagenase Injection: This treatment involves injecting an enzyme that breaks down the collagen in Dupuytren cords. The injection is followed by finger manipulation to straighten the digit. Success rates are good, with about 75% of patients showing improvement, though recurrence can occur.
Surgery: Surgical intervention is recommended for severe cases that significantly impair hand function. Options include:
- Fasciectomy: Removing the diseased tissue
- Dermofasciectomy: Removing diseased tissue along with overlying skin
Surgery allows more complete removal of diseased tissue but requires longer recovery and rehabilitation.
Rehabilitation
Rehabilitation is crucial after treatment, especially following surgery. Hand therapy typically includes:
- Range of motion exercises
- Scar tissue management techniques
- Swelling control methods
- Splinting programs (often including night extension splints)
Physical therapy is usually recommended for at least three months to prevent contractures from returning. The full benefits of treatment may take 6-8 weeks to become apparent.
Prevention
Unfortunately, there’s currently no way to prevent Dupuytren’s contracture from developing. Since the exact causes aren’t fully understood and the condition often appears without warning, prevention strategies don’t exist.
Given that the condition runs in families, discussing your family history with your healthcare provider may be helpful for early detection and monitoring.
Living With Dupuytren's Contracture
Living with Dupuytren’s contracture varies greatly depending on severity. Many people with noticeable nodules or cords experience minimal problems. However, significant curved fingers can pose considerable challenges, affecting:
- Daily activities like grasping objects
- Work performance
- Overall quality of life due to hand contracture
The condition can involve periods of progression and stability. Since there’s no cure, contractures commonly return even after successful treatment. Effective management involves:
- Following your healthcare provider’s instructions
- Performing prescribed stretches
- Consistently wearing prescribed splints or braces
- Working with a team including your primary doctor, hand therapist, and surgeon
Treatment should only be pursued when symptoms limit your motion, as all treatments carry potential risks.
Key Takeaways
- Dupuytren’s contracture causes thickening of hand tissue, leading to finger curls and curved fingers
- The condition most commonly affects ring and little fingers and often occurs in both hands
- Dupuytren’s contracture symptoms typically begin with palm lumps and progress to fixed contractures
- Risk factors include genetics, age, gender, ancestry, diabetes, smoking, and alcohol use
- Diagnosis relies primarily on physical examination
- Treatment ranges from observation to surgery, depending on severity
- Recurrence after treatment is common across all treatment methods
At Sancheti Hospital, we understand how challenging it can be to deal with hand conditions like Dupuytren’s contracture. Our specialized hand surgery department offers comprehensive care for patients experiencing finger bending problems and hand contracture.
We provide complete evaluation, advanced treatment options including minimally invasive procedures and surgical interventions, and comprehensive rehabilitation programs. Our experienced team of orthopedic surgeons and hand therapists work together to create personalized treatment plans that help restore hand function and improve quality of life.
Whether you’re in the early stages of the condition or dealing with severe contractures, we’re here to guide you through every step of your treatment journey with compassionate, expert care.
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Patient Stories & Experiences
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Frequently Asked Questions
Is Dupuytren's contracture painful?
Dupuytren’s contracture is typically not painful. However, initial lumps in the palm might be sore, and pain can occur if nodules press on nerves.
Is there a cure for Dupuytren's contracture?
No, there is currently no cure for Dupuytren’s contracture. However, symptoms can be effectively managed with various treatment options.
Can Dupuytren's contracture come back after treatment?
Yes, recurrence is common across all treatment methods. The contracture may return after a few years, even following surgery. About 1 in 5 people experience recurrence after surgical treatment.
