Dupuytren's Disease
Treatment Overview
The goal of treatment for Dupuytren's disease is to keep or restore hand function. Dupuytren's disease often is a progressive disease, and recurrence is common. As you review your treatment options, consider the following:
- In the early stages of the disease, you may be able to keep hand function by using splints and doing range-of-motion exercises.2
- If you have increasing disability or pain in your hand(s), your health professional may give you an injection of lidocaine, corticosteroid, or other medicine. But even though medicines may be used to treat symptoms, they do not cure or stop the progression of the disease.
- If disability continues to progress, you may choose to have surgery to release the contracture of your fingers. A sustained program of physical therapy and hand exercises may help you regain mobility after surgery. Dupuytren's disease recurs after surgery nearly half of the time, so reoperation may be necessary to keep hand function.
- Alternative treatments, such as traction devices or exercises, may be used along with surgery to treat Dupuytren's disease.
Initial treatment
Dupuytren's disease often develops slowly. If the tissue between your skin and tendons (palmar fascia) does not thicken to the point that your fingers are bent and cannot be straightened (contracture), you may only need to have your palms checked regularly.
Medicines are not generally used as part of treatment for Dupuytren's disease. But long-acting corticosteroid medicine is sometimes injected directly into the affected area to help manage symptoms of the disease in its early stages, before one or more fingers develop contracture. This medicine may also temporarily help improve hand function.
Ongoing treatment
Treatment for Dupuytren's disease depends upon the severity of the disease. You may notice the characteristic nodules in your palms years before your condition interferes with daily activities, or you may never have a reduction in your range of motion.
A long-acting corticosteroid medicine is sometimes injected directly into the affected area to help manage symptoms of the disease in its early stages, before one or more fingers bends toward the palm (contracture). Medicines under study for relief of Dupuytren's disease include interferon and collagenase.3
Treatment if the condition gets worse
In severe Dupuytren's disease, the tissue between your skin and tendons (palmar fascia) thickens to the point that your fingers are bent and cannot be straightened (contracture). If you lose the ability to wear gloves or hold objects, or if your hands become painful, surgery may be done to relieve the contracture. A skin graft may be done after surgery to cover open areas in the palm.
Surgery can be effective at restoring mobility to your hands, but Dupuytren's disease recurs often and reoperation may be necessary to keep hand function. After surgery, a sustained program—including using splints, stretching, and doing scar tissue massage and hand exercises—may help you regain mobility and prevent complications or recurrences of the disease.4
What to think about
Splints sometimes are used after surgery for about 8 to 10 weeks to help restore hand function and prevent symptoms of Dupuytren's disease from recurring. Splints support the palm and help straighten the finger(s) during the healing process. In some cases, splints are worn only at night, but in others they are worn at all times, except when the wound needs cleaning or during finger exercises. Your health professional will help you learn how and when to wear the splint during recovery.1
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| Author: | Shannon Erstad, MBA/MPH | Last Updated: March 31, 2008 |
| Medical Review: | William M. Green, MD - Emergency Medicine David Pichora, MD, FRCSC - Orthopedic Surgery | |
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