A little known, though common orthopedic condition affecting the hands and fingers, is called Dupuytren’s Disease. While conditions such as carpal tunnel syndrome, cubital tunnel syndrome, tennis elbow and other types of tendinopathic injuries and conditions are readily discussed, little is written on Dupuytren’s disease and the associated nodules and finger contractures that have the potential to dramatically impact hand function if left untreated.
This blog series will take a closer look at this particular condition and the exciting things that are changing treatment options available to chronic sufferers.
About Dupuytren’s DiseaseA progressive condition, Dupuytren’s disease causes the fibrous tissue of the Palmar Fascia in the hand to shorten and thicken, forming scar tissue or nodules. These nodules can grow together and form tight, restricting “cords,” which limits finger extension and results in contractures. Generally located in the palm at the base of the ring and little fingers, a Dupuytren’s Contracture can dramatically impact hand function.
While little is known about what prompts Dupuytren’s disease, it is believed to be a hereditary condition. It is also more frequently seen in men over the age of 40, those of Northern European descent and those who smoke, use alcohol or have diabetes.
While a small percentage of cases can be resolved conservatively, utilizing cortisone injections, heat ultrasound therapy and stretching exercises, those suffering from chronic contractures now have a less invasive option to traditional surgery - Percutaneous Needle Fasciotomy (PNF), or Needle Aponeurtomy (NA).
PNF is considered when Dupuytren contractures cause problems with hand function, either as a result of tightening or contracture of the cords affecting nearby digits, or if there is a fixed flexion contracture of the middle finger joint, known as the proximal interphalangeal (PIP) joint. The procedure is also considered when contracture of the metacarpophalangeal (MCP) joint reaches 30 degrees to 40 degrees.
Until recently, open surgery was the only option for patients suffering from severe Dupuytren contractures. Today, the needle aponeurotomy, first practiced with great success in Europe, is a minimally invasive surgical approach to addressing the contractures and restoring hand and finger function.
More on this procedure will be discussed in Part Two of our Dupuytren Series. Read more now onDupuytren’s Disease and PNF.
