Dupytren's Contracture Treatment
There is no way to stop permanently or cure Dupuytrens Disease and Dupuytrens Contracture. It is not dangerous and does not become malignant but it may become disabling. Even with the treatment described below, the recurrence rate is between 30 - 50% after five years. Dupuytrens Contracture usually progresses very slowly and may not be troublesome for years.
If a painful lump is present, an injection may help diminish the pain. If pain is persistent, if fingers cannot be straightened completely or the fingers are bent and begin to interfere at all with use of the hand, a procedure to alleviate the problem should be done. The longer fingers remain in a bent or curled position, the more difficult it becomes to straighten them and the worse the functional outcome will be.
Treatment Options
Open Surgery (OS):In an operating room, under general anesthesia and using a scalpel, zig-zag incisions are made into the fingers and palm of the hand. The tough, fibrous tissue is carefully dissected and removed. This procedure is known as a fasciectomy. Stitches are commonly used to close the wounds although sometimes the wounds are left open to heal gradually. Other times skin grafts are used. Following the operation, physical therapy normally is necessary. The recurrence rate for contracture is 30 - 50% after five years.
Needle Aponeurotomy (NA)/Needle Release (NR):This is an office procedure. It is non-surgical. Using a small hypodermic needle instead of a scalpel, the contracting bands beneath the skin are released. The fingers are stretched and straightened. The correction is immediate and lasting. Patients usually go about their regular activities the following day. Formal physical therapy is rarely needed. The functional results, except with the possible exception of the most severe deformities, are the same as with OS. Complications following NA treatment are fewer. The costs for NA are about one-fifth of those for OS.
(This is a technique developed and refined in France by rheumatologists Lermusiax, Badois and others since the 1970's. The method now is being utilized extensively in France, Italy, Germany, and Switzerland. It is supported in the British Journal of Hand Surgery. Since the technique originated elsewhere and with non surgeons, the knowledge of and acceptance by conventional U.S. hand surgeons will probably be delayed.)
Other Treatments
- Enzyme injections with collagenase (Cordase) attempting to break down the tough bands and improve function are being tried on an experimental basis. Although early results were hopeful, these studies have since been temporarily discontinued. The injections are unavailable for general use.
- Radiation: has been tried on a limited basis. Alteration in finger sensation and skin desquamation have been complications. There has been concern that subcutaneous scarring will interfere should eventual surgery be necessary.
- Diet modification: of unproven value.
- Acupuncture: of unproven value.
- Physical Theraphy: beneficial only after open surgery.
Learn more about our recommended Treatment option.