Dupuytren’s disease is a condition causing thickening in the skin of the palm and sometimes contracture of the fingers. Dupuytren’s is treated by Dr. Peter G. Fitzgibbons, MD at The Centers for Advanced Orthopaedics: Maryland Orthopedic Specialists Division. Dr. Fitzgibbons performed fellowship-training in hand, wrist, and elbow surgery through the Harvard Hand & Upper Extremity Fellowship based at Brigham & Women’s Hospital in Boston. With locations in both Germantown and Bethesda, Maryland, he and a team of orthopaedists, hand therapists, and physical therapists offer a comprehensive range of services covering the diagnosis and treatment of Dupuytren’s contractures.
Dupuytren’s disease is a genetic disorder with its origins linked to Northern Europe, although it is variable in the degree to which it affects people who have the genetic predisposition. Sometimes patients have a little bit of thickening in the palm, and sometimes they develop significant thickening that develops up into the fingers and pulls them down into the palm (contracture). The timing of this process is also variable, although at its fastest it progresses over a matter of months. For more information see: http://www.assh.org/handcare/hand-arm-conditions/dupuytrens-contracture.
There is no cure for the underlying genetic disorder, so treatment of Dupuytren’s focuses on the thickening and contractures. For the most part, the palmar thickening itself doesn’t cause pain or symptoms, and so it is rarely treated specifically. When contractures develop that impair the function of the hand, the options include an injection of an enzyme that dissolves the collagen in the thickened tissue, using a needle to disrupt the thick cords that develop, or performing a surgery to remove the diseased tissue. Which method is best and when to perform them is different for everyone. Dr. Fitzgibbons works with patients to determine which treatment is ideal for them.
Surgery for Dupuytren’s contracture is performed as an outpatient procedure and is often done with local anesthesia. During the surgery an incision is made and contracted tissue is removed, allowing the finger to straighten. Dr. Fitzgibbons performs most of these procedures at the Massachusetts Avenue Surgery Center, an outpatient surgery center that provides a safe, patient-oriented experience in a
friendly and comfortable environment.