Dupuytren’s Contracture
A condition characterised by thickening and tightening of tissue in the palm, limiting finger movement
Dupuytren’s contracture is a progressive condition where the connective tissue under the skin of the palm thickens and forms hard knots. Over time, this causes one or more fingers, typically the ring and little fingers, to curl inward towards the palm, limiting hand function. While painless, Dupuytren’s contracture can impact grip strength and dexterity, affecting everyday activities. At Melbourne Orthopaedic Clinic, Prof. Sallen specialise in diagnosing and treating Dupuytren’s contracture, providing options that restore hand function and improve quality of life.
Causes of Dupuytren’s Contracture
Several factors can increase the risk of Dupuytren’s contracture, including:
- Genetics: A family history of Dupuytren’s contracture significantly increases the likelihood of developing the condition.
- Age and Gender: Dupuytren’s contracture is more common in individuals over 40 and affects men more frequently than women.
- Medical Conditions: Certain health conditions, such as diabetes and epilepsy, have been associated with an increased risk of Dupuytren’s contracture.
- Lifestyle Factors: Smoking and alcohol use have been linked to a higher prevalence of Dupuytren’s contracture, likely due to effects on circulation and connective tissue health.
Symptoms of Dupuytren’s Contracture
Dupuytren’s contracture develops slowly and may initially go unnoticed. Symptoms can include:
- Nodules in the Palm: Small, firm lumps or nodules that may feel tender at first but typically become painless over time.
- Thickened Cords: Ridges or bands under the skin in the palm that gradually tighten, pulling the affected fingers towards the palm.
- Finger Flexion: The affected fingers may bend and remain curled toward the palm, limiting the ability to straighten them fully.
- Reduced Hand Function: Difficulty gripping objects or performing tasks requiring an open hand due to restricted finger movement.
Diagnosis of Dupuytren’s Contracture
At Melbourne Orthopaedic Clinic, diagnosing Dupuytren’s contracture involves a comprehensive assessment, including:
- Physical Examination: A thorough evaluation of the hand to identify nodules, thickened cords, and finger flexibility.
- Range of Motion Tests: Tests to determine the degree of flexion and how it impacts hand functionality.
- Assessment of Medical History: Gathering information about family history, lifestyle factors, and any underlying conditions that may contribute to Dupuytren’s contracture.
Treatment Options for Dupuytren’s Contracture
Treatment for Dupuytren’s contracture aims to improve finger mobility and hand function. At Melbourne Orthopaedic Clinic, we provide a range of options tailored to each patient’s condition and lifestyle needs.
Non-Surgical Treatments
For individuals with mild Dupuytren’s contracture, non-surgical treatments may offer relief, including:
- Needle Aponeurotomy: A minimally invasive procedure where a needle is used to break up the thickened cords, allowing the fingers to extend more freely.
- Collagenase Injections: Enzyme injections that dissolve the tough cords in the palm, enabling the fingers to straighten with improved range of motion.
- Physiotherapy: Hand therapy exercises can improve range of motion, support functional hand use, and delay further contracture.
Surgical Treatments
For advanced cases where the contracture severely impacts daily activities, surgery may be recommended, including:
- Fasciectomy: This procedure involves removing the thickened tissue to release the affected fingers and improve mobility.
- Dermofasciectomy: In cases of recurring contracture, a dermofasciectomy, which involves removing the affected tissue and covering the area with a skin graft, may be performed to minimise recurrence.
At Melbourne Orthopaedic Clinic, our team is dedicated to offering personalised care for Dupuytren’s contracture. We will work with you to develop a tailored treatment plan focused on reducing symptoms, restoring hand function, and enhancing your quality of life.
