Shortening of fibrous tissue can cause a decrease in the range of motion for muscles. This is the case with Dupuytren’s contracture. Most individuals who have this condition lose the mobility of their fourth and fifth fingers, or ring finger and little finger. It can also extend to the other fingers and sometimes the thumb can be affected.
Anatomy of Dupuytren’s Contracture
The palmer fascia is a tough fibrous layer of tissue in the palm of the hand. It is sandwiched between the skin of the palm and the underlying tendons. The tendons allow the fingers to flex.
If the palmer fascia begins to thicken and shorten, it pulls the affected fingers toward the palm. The condition often begins as a sensitive nodule in the palm of the hand. Sometimes you can see lumps or dimples develop, causing the skin in the area to pucker.
In its earliest stages, there may be pain; however, that goes away after a while. The condition may cause tough bands resembling cords or tendons to develop in the palmer facia, but no tendons are involved. As time goes on, it becomes increasingly difficult to fully extend the fingers.
Mild cases of Dupuytren’s contracture are usually not treated if the individual is able to continue to perform necessary functions. More severe cases are treated in a number of fashions, depending on the severity of the problem.
In the early stages, corticosteroid injections can be used for pain relief and to reduce inflammation. The nodule is injected with the corticosteroid. This treatment often slows the progression of Dupuytren’s contracture.
A relatively new and effective treatment is injection with collagenase clostridium histolyticum (CCH), which was approved by the Food and Drug Administration (FDA) in 2010. This treatment for the condition is known by its brand name, Xiaflex. Most patients receiving this treatment have good results and express satisfaction with it.
CCH injections are used to weaken the fibrous cords. When they are sufficiently weakened, the doctor will pull on the cords until they break. The fingers are released and can be fully extended and used again.
Surgery may be the option of choice if an individual has very limited use of the hand, or if the fibrous tissue has wrapped around arteries and nerves. Surgery is usually an outpatient procedure with local anesthetic. Some cases may require general anesthesia, but an overnight hospital stay is seldom required.
Sovereign Rehabilitation offers effective treatments for Dupuytren’s contracture. Our team of professionals provides excellent care and follow up. Call us to schedule an exam and consultation.
Posted on behalf of Sovereign Rehabilitation
5555 Peachtree Dunwoody Rd, Suite 225
Atlanta, GA 30342
Phone: (404) 835-3340