Dupuytren’s Disease
What is Dupuytren’s Disease?
Dupuytren’s disease, or Dupuytren's contracture, is an abnormal thickening of the connective tissue, the fascia, that lies just beneath the palm. The debilitating condition often begins with a small lump in the palm, with the progressive formation of rope-like cords throughout the hand. These can cause contractures and prevent patients from opening their fingers and placing their hand flat. Dupuytren’s disease is usually a painless disorder. The real dysfunction comes from the contracture, or inability to extend the fingers. It can also cause a complete loss of mobility.
Treatment
Historically, surgical intervention has been used to treat this difficult problem, as there are no known medical treatments. The surgery used is called a subtotal fasciectomy. During this surgery, the abnormal cords and nodule are removed through skin incisions. The abnormal tissue must be meticulously removed from the neighboring nerves, blood vessels, and tendons. In recent years, a less invasive procedure has been developed to help treat this problem.
A technique known as needle aponeurotomy (also called percutaneous needle fasciotomy) is a new treatment for this old problem. Needle aponeurotomy is a minimally invasive, in-office procedure which requires only local anesthetic and avoids the need for skin incisions. The abnormal cords are transected with the use of small hypodermic needles. The procedure was developed in France and has been practiced throughout the United States for several years. It avoids the risks of the subtotal fasciectomy but requires attention to proper technique and knowledge of anatomy to avoid injury to the surrounding tissues.
Who is a Candidate?
Not everyone is a candidate for this procedure and, unfortunately. Dupuytren’s disease has a high recurrence rate. Recurrence occurs 50% of the time at five years following a subtotal fasciectomy and at three years following a needle aponeurotomy. However, the lower complication rate and faster recovery from needle aponeurotomy make the treatment very appealing to patients and hand surgeons.
See a Specialist
This is a welcome addition to our available treatments for this difficult condition. A consultation to discuss whether a particular patient with Dupuytren’s disease is a good candidate for this procedure and a full discussion of the potential risks and benefits are recommended. To learn more about these treatment options, please request an appointment online, or call 509-344-HAND (4263).
Appointment Resources
Once you have scheduled your appointment with one of our specially-trained hand doctors, please use the link below to obtain our new patient forms and browse through our tips and preparation suggestions for your appointment.
“Dupuytren's contracture is a pesky disease. It starts as a small lump under a finger. Eventually, a fibrous cord like thing forms and causes a finger to bend inward. With the last go around, my ring finger and third finger were turning inward. I couldn't lay them flat on the table. Dr. Lin performed surgery and I'm fine. My fingers are straight. He assured me he could correct the problem and that he did. I've got it going on in my little finger now. It's a slow process, but when it gets pulled forward to a ninety-degree angle, Dr. Lin will do surgery. He can take care of it. It won't be straight, but I'll get some flexibility back. I know I will. Thanks to Dr. Lin.” — Lois O.