Dupuytren’s disease is a contracture of the fingers that causes the fingers to curl inward toward the palm. Though it is typically not painful, this condition can interfere with everyday activities such as wearing gloves or getting your hand into your pocket which often leads patients to seek treatment.
Dr. S. R. Brown is a board certified orthopaedic surgeon with fellowship training in hand and upper extremity surgery. In addition to her experience with surgical procedures to correct Dupuytren’s disease, Dr. Brown is also an authorized provider of Xiaflex, a nonsurgical, noninvasive injection that can be used to treat this condition. Xiaflex is a great option for patients who wish to avoid surgery, but have contracture in the fingers that affects everyday life. Xiaflex can be performed in the office setting without any anesthesia.
Causes & Symptoms of Dupuytren’s Disease
Dupuytren’s disease develops when the fascia, bands of tissue that anchor the skin to the palm of the hand, begins to thicken and tighten. Nodules begin to form under the skin of the palm, pulling on the overlying skin. Eventually, the fascia begins to thicken and tighten, pulling one or more of the fingers or the thumb into a bent position.
Dupuytren’s disease is typically a hereditary condition, most often present in men aged 40-70. It tends to occur most often in men of northern European descent. Medical conditions like diabetes or repetitive traumatic injuries to the hand can also increase the risk of developing Dupuytren’s disease.
This condition tends to be a slow progression. The contracture in the fingers is usually mild at first, but can progress to the point that it is difficult to straighten the finger. Dupuytren’s disease is typically not painful, but patients may decide to seek treatment if it affects their daily life or occupation.
Treatment Options for Dupuytren’s Disease
If a patient can live with the effects of Dupuytren’s disease, treatment is not necessary. However, if it does affect a patient’s activities or work, Dr. Brown offers both surgical and nonsurgical options.
Xiaflex is a noninvasive, nonsurgical injection used to treat Dupuytren’s disease. Patients may prefer this option because it has a quicker recovery time than surgery and can be performed in an office setting. Dr. Brown administers the injection in her office. She injects the Xiaflex medication into the fascia bands that are causing the finger to contract. The hand is then wrapped in gauze and ACE bandage, and the patient is instructed to limit movement in the hand for 24 hours. The Xiaflex injection helps to weaken or dissolve the contracted tissue. The following day, the patient returns to the office, and Dr. Brown will manipulate the finger to break up the tissue causing the contracture. This often results in greater range of motion in the affected fingers.
Following the injection, patients do at-home exercises or work with occupational hand therapy. Patients must also wear a splint at night for 4 weeks.
Surgery for Dupuytren’s Disease
If a patient meets the criteria to have surgery to address the contracture caused by Dupuytren’s disease, Dr. Brown can perform an outpatient procedure to excise or cut out the tissue causing the contracture. After surgery, patients may need to wear a splint and will be instructed on proper wound care for the incision site. Physical or occupational hand therapy may also be recommended.
Can Dupuytren’s Disease Recur?
Whether patients choose Xiaflex or surgery to treat Dupuytren’s disease, there is a chance that the contracture can recur. It is important to note that there is currently no “cure” for the underlying causes of Dupuytren’s disease—treatment can only help with reducing the contracture of the fingers. If the contracture does recur, patients are able to repeat Xiaflex injections or surgical treatment.
Dupuytren’s Disease Treatment in Murfreesboro, TN
S. R. Brown, MD is a board certified orthopaedic surgeon with additional subspecialty training in hand and upper extremity surgery. She provides treatment for several conditions affecting the hand, including Dupuytren’s Disease. As an experienced and skilled hand surgeon, Dr. Brown offers surgical options for Dupuytren’s disease, as well as newer treatments like Xiaflex that may help patients avoid the need for surgery.