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Dupuytren’s Disease of the Hand and Fingers
What is Dupuytren’s Disease?
Dupuytren’s disease is a common condition affecting the hand and fingers. It develops in the tissue beneath the skin of the palm, where thickening can gradually form. Over time, this thickened tissue may turn into a tight band, which can begin to pull one or more fingers into a bent position.
The condition is usually slow and progressive. It may affect a single finger or several fingers, and it can occur in one hand or both hands. In the early stages, it may cause very little trouble, but as it progresses it can interfere with normal hand function and everyday activities.
Symptoms and Progression
Many patients first notice a small lump, thickening, or puckering in the palm of the hand. As the condition advances, a firm band may develop beneath the skin. This may gradually lead to a contracture, where the finger can no longer be fully straightened.
The ring and little fingers are most commonly affected, although any finger may be involved. In more advanced cases, the stiffness and bending can make simple tasks such as washing, putting the hand in a pocket, wearing gloves, or gripping larger objects more difficult.
Diagnosis
Diagnosis is usually made by clinical examination. The hand is carefully assessed for nodules, bands, skin changes, and any loss of finger movement or straightening.
Occasionally, an X-ray may be requested to rule out any underlying arthritis or another cause of finger stiffness, particularly when the symptoms are not entirely typical.
Treatment
Treatment depends on the severity of the condition and the extent to which it affects hand function.
In mild cases, where there is only minimal thickening and little or no contracture, conservative treatment may be appropriate. This usually involves observation and review over time, especially if symptoms are not significantly affecting daily activities.
For selected patients with a single Dupuytren’s band, a percutaneous Dupuytren fasciotomy may be a suitable option. This is a minor day-case procedure performed under local anaesthetic. It involves dividing or lengthening the tight Dupuytren’s band in order to improve finger straightening. Recovery is generally quicker than with open surgery, often taking around a couple of weeks. However, this procedure is only suitable for certain types and degrees of Dupuytren’s disease, and whether it is appropriate would be decided by Mr. Ayoub during assessment.
Where the disease is more established or the finger contracture is more significant, the more common treatment is an open surgical release of Dupuytren’s disease. This involves making an incision in the palm and/or finger to release or remove the diseased tissue and improve the position of the finger. The operation is usually performed as a day-case procedure, most often under general anaesthesia, although the type of anaesthetic may vary depending on the individual case.
After surgery, the hand will be bandaged and will usually be out of action for approximately 2 to 4 weeks, depending on the extent of the procedure and the speed of recovery.
Mr. Ayoub will be able to assess the severity of your Dupuytren’s disease during consultation and advise you on the most appropriate treatment option. Back…
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