Dupuytren’s contracture is condition that affects the use and mobility of a person’s fingers and hands. As Dupuytren’s contracture progresses, small nodules (lumps) under the skin begin to thicken and form bands. As these bands tighten, it causes the hand and fingers to contract and curl. Dupuytren’s contracture is hereditary and affects men more than women; however, certain activities such as drinking or certain conditions such as diabetes or seizures increases a person’s risk of developing Dupuytren’s contracture. As more nodules form into tightening bands, the range of motion in the hand is decreased; because everyday activities like holding a pen and writing, shaking hands, or picking up objects off the floor can become difficult or even impossible, finding a treatment to help reduce the symptoms is key to maintaining at least partial use of an afflicted hand. Steroid injections, enzyme injections, and surgery are the top three treatment options for Dupuytren’s contracture.
Top 3 Dupuytren’s Contracture Treatments
- Steroid injections
- Enzyme injections
- Surgery
Steroid injections
The first symptom of Dupuytren’s contracture is the appearance of small nodule, which is a lump beneath the skin. These nodules, often referred to as Dupuytren’s nodules, will continue to harden and form the bands that cause the hands to become misshapen. The hope is to treat the nodes before they cause damage. When a patient opts to use steroid injections as a treatment, it is these nodules that are targeted. Steroids are injected directly into nodule, and several injections are needed to reduce the size of the nodule. While this treatment is effective in the early stages of the Dupuytren’s contracture, it will not cure a hand that already has a contracture.
Highlights:
- In-office procedure with no downtime
- Effective at slowing the progression of the disorder
- Multiple injections needed
Enzyme injection
While steroid injections are only effective during the early stages of Dupuytren’s contracture, enzyme injections may be used as part of a treatment plan if there is a contracture already present. Many doctors use an enzyme injection called Xiaflex, which contains collagenase, an enzyme that breaks down collagen. Because the toughened bands in a contracture are made of collagen, an enzyme injection can break up the tightened band. One enzyme injection is capable of eliminating a contracture; however, if the contracture is still present after the injection, stretching exercises work in concert with the enzymes to straighten the hand. Most patients will not need more than 2 injections in order to reduce the symptoms. Side effects of the enzyme injection are minimal and include bruising or slight pain at the injection site.
Highlights:
- Treats contractures and straightens hand
- 1-3 injections needed to be successful
- Minimal side effects
Surgery
In the event that Dupuytren’s Contracture progresses to the point where a patient loses most – if not all- motion and ability to control the hand, surgery may be a suitable treatment option. Depending on how severe the contracture is and how many knuckles are involved, a surgeon will recommend either an open surgery or a needle aponeurotomy. During an open surgery, the surgeon removes all of the tightened bands of tissue. Alternatively, during a needle aponeurotomy, which is a much less invasive procedure, a hypodermic needle is used to cut the tightened bands of tissue to improve mobility. Physical therapy may be required after an open surgery, but it much less likely to be needed after a needle aponeurotomy.
Highlights:
- Open surgery
- Needle aponeurotomy
- May require physical therapy afterwards
Conclusion
Even though Dupuytren’s contracture is hereditary, it can affect anyone regardless of gender or age. Though the affects may not always be debilitating, the onset of symptoms is a sign that the condition may worsen over time. If you or someone you know suffers from Dupuytren’s Contracture, speak with your doctor about treatment options. With the right treatment plan , you can find comfort and improve mobility while slowing the progression of the condition.