Understanding Dupuytren’s Disease

Dupuytren's disease is caused by a shortening, thickening, and/or excess of connective tissue in the palm of the hand. Firm nodules, cords, and pits in the palm develop. Over time, the disease can pull your fingers into a bent position downward into your palm. 

At Maryland Orthopedic Specialists, our hand specialist, Peter G. Fitzgibbons, MD, is experienced in helping both mild and severe cases of this condition.

You probably have lots of questions about your diagnosis, treatment, and prognosis. Here are some of the important things to know about Dupuytren’s disease.

What causes Dupuytren’s disease?

Dupeytren’s disease describes connective tissue in the palm that becomes tight and constrictive enough to force the fingers to bend inward toward the palm. Sometimes this is due to the development of excess connective tissue. 

You may notice cords of contractive tissue on your palm and fingers that look like tendons, but the disease has nothing to do with your tendons.

The reason certain people develop Dupuytren’s disease isn’t fully understood. It most often develops in men and is common in those of northern European descent. 

Usually, Dupuytren’s disease starts to show up in your 40s or later and may run in families, though sometimes a person with no family history of the disease develops it.

When should I suspect I have it?

Even mild cases of Dupuytren’s disease have noticeable symptoms. Most often, Dupuytren’s disease affects both hands. You usually notice lumps and pits under the skin of your palm at first.

With time, you see thick cords on the palm in line with the fingers that start to prevent you from putting your hand flat on a table or into pockets. You may not be able to grasp large objects.

Eventually your fingers start to bend into the palm. Usually the ring and pinky finger are most often affected, but in severe cases, other fingers are involved as well.

Dupuytren’s disease isn’t usually painful, but it does interfere with your hands’ functioning and worsens with time.

Can Dupuytren’s disease be cured?

While we can’t cure Dupuytren’s disease (no one can), Dr. Fitzgibbons offers treatments that restore function to your hand (or hands).

The following treatments can help. The one that’s best for you depends on the severity of your condition.

Needling

Dr. Fitzgibbons may insert a needle through your skin to break up the tissue causing tightness in your fingers. The contractures can return, but needling can be done again and again.

While needling isn’t the most effective treatment, it’s the least invasive option. It requires no incisions, can be done on several affected fingers in the same appointment, and requires minimal follow-up physical therapy.

Collagen-dissolving injections

Dr. Fitzgibbons may administer injections of an enzyme that softens and weakens the connective tissue so he can then break the contracted cords and straighten your fingers.

For advanced cases of Dupuytren’s disease, Dr. Fitzgibbons may recommend surgery. During the procedure, he removes any diseased tissue in your palm. Surgery is effective in that the results are comprehensive and long-lasting. You will need physical therapy and time to recover, of course.

If you’ve been diagnosed with Dupuytren’s disease or suspect you have it, contact us at Maryland Orthopedic Specialists for expert management and treatment. Call our Bethesda or Germantown, Maryland, office for a consultation with Dr. Fitzgibbons, or book online today.

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