Dupuytren's contracture is a hand condition that causes the fingers to bend inward towards the palm. It occurs due to the thickening and tightening of the tissue beneath the skin in the palm of the hand. While the exact cause is unknown, certain risk factors such as age, gender, family history, and certain health conditions may increase the likelihood of developing Dupuytren's contracture.
There are several treatment options available for Dupuytren's contracture, ranging from non-invasive methods to surgical interventions. The choice of treatment depends on the severity of the condition, the impact on hand function, and the patient's preferences. Here are some of the best treatments for Dupuytren's contracture:
In mild cases where the contracture does not significantly affect hand function, observation and monitoring may be the initial approach. Regular check-ups with a hand specialist can help track the progression of the condition and determine if any treatment is necessary.
Physical therapy can be beneficial in managing Dupuytren's contracture. Therapeutic exercises and stretching techniques can help maintain hand mobility, improve finger extension, and prevent further contracture. Physical therapists can also provide guidance on hand exercises that can be performed at home.
Medications are not a primary treatment for Dupuytren's contracture but can be used in certain cases. Injectable collagenase clostridium histolyticum is an FDA-approved medication that can be injected into the affected tissue to break down the collagen and improve finger extension. However, this treatment is not suitable for all patients and should be discussed with a healthcare professional.
Splinting involves wearing a custom-made splint to stretch the affected finger(s) and maintain them in an extended position. This can help slow down the progression of contracture and improve hand function. Splinting is often used in combination with other treatments, such as physical therapy.
Needle aponeurotomy, also known as percutaneous needle fasciotomy, is a minimally invasive procedure performed under local anesthesia. During this procedure, a needle is inserted into the palm to divide and release the contracted tissue, allowing the finger(s) to straighten. Needle aponeurotomy can be an effective treatment for mild to moderate contractures and has a shorter recovery time compared to surgery.
Collagenase injection involves injecting an enzyme called collagenase into the Dupuytren's cord, which helps break down the collagen and release the contracted tissue. This procedure is typically performed in an outpatient setting and may require subsequent manipulation of the finger(s) to further extend them. Collagenase injection can be an alternative to surgery for certain patients.
Surgery is often recommended for severe cases of Dupuytren's contracture or when other treatments have not been successful. The goal of surgery is to remove the thickened tissue and release the contracture, allowing for improved hand function. There are different surgical techniques available, including fasciectomy, fasciotomy, and dermofasciectomy. The choice of surgery depends on the extent of the contracture and the surgeon's expertise.
Radiation therapy is a less common treatment option for Dupuytren's contracture. It involves the use of low-dose radiation to reduce the growth of abnormal tissue. Radiation therapy is typically reserved for cases where other treatments have failed or are not suitable. It may be used as an adjunct to surgery or as a standalone treatment.
It is important to note that the effectiveness of each treatment option can vary depending on the individual case. Consulting with a hand specialist or a healthcare professional is crucial to determine the most appropriate treatment plan for Dupuytren's contracture.