Dupuytren's Contracture
Dupuytren's Contracture
Dupuytren's disease is a common hand disorder that normally begins as nodules in the hand. Thick, scar-like tissue forms in the palm and progresses toward the fingers. Dupuytren's is common among peoples origination from Northern Europe, but can be seen in people of any race. President Reagan had the Dupuytren's disease removed from his hand during his term in office.
The nodules of Dupuytren's disease occur in the fascia of the hand, causing a shortening of the fascia and contracture of the skin of the palm. When the disease migrates into the fingers, it often causes the fingers to curl up. Eventually, the fingers can no longer extend.
Indications for removal of Dupuytren's disease from the hand include both pain and decreased function. Many times, Dupuytren's nodules are painless, but if they cause pain which limits use of the hand they should be removed. If there is 30 degrees flexion of the first joint adjacent to the palm or there is any flexion of the second joint adjacent to the palm, surgery should be performed before the contractures of the finger become permanent.
In treating this disease, most surgeons recommend excision of the diseased fascia. The surgery is commonly done on an outpatient basis and takes one to two hours to complete. Post-operatively, the patient is usually able to return to normal activities within two to four weeks. Patients tend to do very well with the surgical correction of the disease, as long as surgery is performed before finger flexion becomes permanent.
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