Mr Ravi Mallina, Consultant Orthopaedic Surgeon specialising in hand and wrist conditions | 20/07/2021

What is Dupuytren's contracture of the hand? Is it painful?

Dupuytren's contracture

Dupuytren's contracture is a disorder of the hand caused by the thickening of a layer of tissue called the fibrous tissue located immediately beneath the skin. The cause of this condition is not clearly known, though it was once believed to be linked to the Vikings ancestry.

Typically, dupuytren's manifests in the forties as a small lump in the palm or thick cord like structure extending from the palm to the fingertip. The most affected fingers are typically the little and or ring finger.

Is Dupuytren's painful?

In early stages of the disease known as the "proliferative phase", the condition can be painful and accompanied by a tender lump in the palm which usually does not need any treatment. Even so, it is advised that you never ignore any lump or bump, especially if it is progressively increasing in size and causing significant pain. Always seek professional advice. In most instances, dupuytren's does not cause pain.

In advanced stages, patients may complain of difficulty; washing their face, wearing gloves, using computers or playing musical instruments. If you begin to experience any difficulties, you should seek further advice.

What are the treatment options available?

Several treatment options exist for dupuytren’s contracture depending on the age of the patient, severity of the condition and type of the finger joint involved in the disease. Your surgeon will discuss several treatment options available as part of the treatment ladder for dupuytren's disease. Below are some possible treatment modalities:

  • Needle aponeurotomy
  • Collagenase injection
  • Partial fasciectomy
  • Segmental fasciectomy
  • Dermofasciectomy plus full thickness skin graft

I heard about a collagenase injection called Xiapex, which is used for treatment of Dupuytren's. How can I receive it?

Sadly, the manufacturers of the collagenase injection have withdrawn the drug from use for dupuytren's disease. However, the British Society of Surgery of the Hand in its recent Newsletter (October 2020) suggested importing an equivalent drug to the UK from USA through Mawdsleys Unlicensed Medicines portal. This process has the provisional approval of UK regulatory agency, the MHRA. Contact Mr Ravi Mallina, Consultant Hand and Wrist Surgeon, to find out more.

How long will it to take to recover from Dupuytren's surgery?

Recovery from dupuytren’s surgery really depends on the treatment modality offered. Patients with needle aponeurotomy (a procedure done under local anaesthesia) can potentially go back to work the following day, whilst patients undergoing dermofasciectomy plus full thickness skin graft may take as long as four to six weeks to return to work, depending on their type of employment.

For more information, please give us a call or fill out an enquiry form.

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