Materiały źródłowe

• #1 Dupuytren’s Disease – Dupuytren’s Contracture – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/dupuytrens-disease/

  Dupuytren’s disease is a condition that affects the palmar fascia the fibrous layer of tissue that lies underneath the skin and above the tendons, nerves, blood vessels, and bones in the palm and fingers. […] In some people, a worsening Dupuytren’s contracture can interfere with hand function, making it difficult to perform daily activities. When this occurs, there are nonsurgical and surgical treatment options available to help slow the progression (worsening) of the disease and improve motion in the affected fingers. […] If the contracture interferes with hand function, your doctor may recommend surgical treatment. The goal of surgery is to reduce the contracture and improve motion in the affected fingers. […] Although its effects vary from patient to patient, Dupuytren’s usually progresses (gets worse) very slowly and may not become troublesome for many years. In fact, for some patients, the condition may never progress beyond developing lumps in the palm.

• #2 Dupuytren contracture – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dupuytrens-contracture/symptoms-causes/syc-20371943

  Dupuytren contracture is a condition that causes one or more fingers to bend toward the palm of the hand. The affected fingers can’t straighten completely. It most often affects the two fingers farthest from the thumb. […] There’s no cure for Dupuytren contracture. Treatments can relieve symptoms and slow how quickly the condition gets worse. […] Dupuytren contracture gets worse slowly, over years. The condition begins with a firm lump in the palm of the hand. This lump can be painful or painless. […] Over time, the lump can extend into a hard cord under the skin and up into the finger. This cord tightens and pulls the finger toward the palm, sometimes severely. […] Risk factors for Dupuytren contracture include: Age. Dupuytren contracture occurs most commonly after the age of 50. […] Sex. Men are much more likely to develop Dupuytren than are women. In men, symptoms may be worse and progress more quickly. […] Family history. Dupuytren contracture often runs in families. […] Diabetes. People with diabetes have an increased risk of Dupuytren contracture. […] Tobacco and alcohol use. Smoking tobacco and drinking alcohol both increase the risk of Dupuytren contracture.

• #3 Dupuytren’s Contracture Overland Park KS | Hand Surgery Lee’s Summit MO

  https://www.kcbj.com/dupuytren-s-contracture-orthopedic-musculoskeletal-care-overland-park-kansas-city/

  Dupuytrens contracture is a hand condition where thickening of the underlying fibrous tissues of the palm causes the fingers to bend inward. This makes it difficult to fully straighten the affected fingers. It commonly occurs in the ring finger and little finger. Occasionally, the middle finger is affected, but the thumb and index finger are rarely affected. […] Dupuytren’s contracture is diagnosed based on your history and a physical examination, without the need for any special tests. The physical examination may involve applying pressing on different parts of your hands and fingers to assess for hardened knots or tough bands of tissue. […] You may not need treatment for Dupuytrens contracture if the condition is not affecting your ability to perform daily activities. However, if you are experiencing pain or are having difficulty using your hands for everyday activities, your surgeon will recommend conservative treatment options to treat your condition. Treatment options will vary depending on the severity of your condition. […] If conservative treatment options fail to resolve the condition, the symptoms persist for 6 months or more, and your quality of life is adversely affected, your surgeon may recommend a surgical procedure to open the tendon sheath and allow more room for the movement of the tendon.

• #4 Patient Education | Concord Orthopaedics

  https://www.concordortho.com/patient-resources/patient-education/topic/87dd7a6db0de0c96774d9d23735f291f

  A Patient’s Guide to Dupuytren’s Contracture […] Introduction […] Dupuytren’s contracture is a fairly common disorder of the fingers. It most often affects the ring or little finger, sometimes both, and often in both hands. It occurs most often in middle-aged, white men. This condition is seven times more common in men than women. Although more common in men of Scottish, Scandinavian, Irish, or Eastern European ancestry researchers agree that genes are not a direct cause of this disease, but predisposes them to this condition. […] This guide will help you understand how Dupuytren’s contracture develops, how the disorder progresses, and what treatment options are available. […] Treatment […] There are two types of treatment for Dupuytren’s contracture: surgical and nonsurgical. The best course of treatment is determined by how far the contractures have advanced. Palmar Fascia Removal (palmar fasciectomy) or release of the diseased cords still remains the gold standard of care for advanced Dupuytren’s contracture.

• #5 Dupuytren’s disease

  https://www.bssh.ac.uk/patients/conditions/25/dupuytrens_disease

  Dupuytren’s disease (also referred to as Dupuytren’s contracture) is a common condition that usually arises in middle age or later and is more common in men than women. Firm nodules appear in the ligaments just beneath the skin of the palm of the hand, and in some cases they extend to form cords that can prevent the finger straightening completely. […] Dupuytren’s disease begins with nodules in the palm, often in line with the ring finger. The nodules are sometimes uncomfortable on pressure in the early stages, but the discomfort almost always improves over time. In about one affected person out of every three, the nodules extend to form cords that pull the finger towards the palm and prevent it straightening fully. Without treatment, one or more fingers may become fixed in a bent position.

• #6 Dupuytren’s disease

  https://www.bssh.ac.uk/patients/conditions/25/dupuytrens_disease

  There is no cure. Surgery can usually make bent fingers straighter, though not always fully straight; it cannot eradicate the disease. Over the longer term, Dupuytren’s disease may reappear in operated digits or in previously uninvolved areas of the hand. […] Surgery is not needed if fingers can be straightened fully. It is likely to be helpful when it has become impossible to put the hand flat on a table, and should be discussed with a surgeon at this stage. The surgeon can advise on the type of operation best suited to the individual, and on its timing. […] After surgery, the hand may be fitted with a splint to be worn at night. Hand therapy is important in recovering movement and function, especially for more extensive surgery and skin grafts. The recovery is variable with regard to the degree of improvement achieved and the time to achieve the final position. The final outcome is dependent on many factors including the extent and behaviour of the disease itself and the type of surgery required.

• #7 Dupuytren contracture – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dupuytrens-contracture/diagnosis-treatment/drc-20371949

  In most cases, Dupuytren contracture can be diagnosed by the look and feel of the hands. Other tests are rarely necessary. […] Treatment involves removing or breaking apart the cords that are pulling your fingers toward your palm. This can be done in several ways. The choice of procedure depends on the severity of your symptoms and other health problems you may have. […] Any treatment of Dupuytren contracture may provide only temporary relief. The contraction of the fingers often returns with time. […] If you have mild Dupuytren contracture, you can protect your hands by avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape. […] Your health care provider might send you to see a bone surgeon. This is often called a referral to an orthopedic surgeon.

• #8 Dupuytren’s Disease – Dupuytren’s Contracture – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/dupuytrens-disease/

  Your doctor will likely talk with you about your general health and medical history and ask about your symptoms. […] Currently, there is no cure for Dupuytren’s; however, the condition is not life- or limb-threatening. […] Physical therapy can help improve strength and function in your fingers and hand, reduce swelling, and aid in wound care. Often, a hand therapist will make a splint for you to wear during recovery. […] Most patients have improved movement in their fingers after surgery. However, because the condition is not „cured” with surgery, about 20% of patients will experience a meaningful degree of contracture recurrence (the contracture comes back). Additional surgery may be required for some patients.

• #9 Facts on Hand: Dupuytren’s Contracture

  https://www.factsonhand.com/

  Take charge of your Dupuytrens contracture treatment […] If you cant lay your hand flat against a table, you may have Dupuytrens contracture. […] The Tabletop Test is a quick test for Dupuytrens contracture that you can do at home. Try laying your hand flat against a tableif you cant lay your hand flat, its time to find a Hand Specialist. They can tell you if you have Dupuytrens contracture and can inform you of your options, including nonsurgical treatment. […] Dupuytrens contracture is a condition that causes collagen to build up in the palm. Over time, it forms a rope-like cord that extends into a finger or fingers, pulling them inward and making you unable to straighten them. […] It is a progressive condition, so these cords can get worse over time. It commonly affects adults over 40 and people with a family history of Dupuytrens contracture. There are both surgical and nonsurgical treatment options available.

• #10 Dupuytren’s Disease: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0701/p86.html

  Dupuytren’s disease is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. […] The disease initially can be managed with observation and non-surgical therapy. […] Surgical referral should be made when metacarpophalangeal joint contracture reaches 30 degrees or when proximal interphalangeal joint contracture occurs at any degree. […] Timing of surgical intervention varies, but surgery is usually performed when the metacarpophalangeal joint contracture exceeds 40 degrees or when the proximal interphalangeal joint contracture exceeds 20 degrees. […] Surgery is recommended if function is impaired, contracture is progressing, or severe deformity is disabling. […] Referral to a hand surgeon is indicated if the MCP joint contracture reaches 30 degrees or if PIP joint contracture occurs at any degree.

• #11 Dupuytren’s Contracture | Cooper University Health Care

  https://www.cooperhealth.org/services/dupuytrens-contracture

  Dupuytren’s contracture is a progressive condition in which theres an abnormal thickening of this tissue at the base of your fingers. […] While theres no cure for Dupuytrens contracture, there are effective treatmentsboth non-surgical and surgicalthat can slow the disease or help ease your symptoms. […] If left untreated, Dupuytrens contracture may prevent you from straightening your fingers fully, interfering with your ability to use your hands for certain tasks. […] Its also important to see a specialist because the symptoms of Dupuytrens contracture can be similar to other conditions such as trigger finger or tendinitis. […] Treatment is tailored to the severity of your condition: Non-surgical injection of an enzyme called collagenase is the standard of care for most cases today. […] Surgery may be indicated in advanced cases when patients have limited use of their hands. […] If you have had surgical or non-surgical treatment for Dupuytrens contracture, wear the hand splints and do the exercises as your doctor prescribes.

• #12 Dupuytren’s Disease: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0701/p86.html

  Dupuytren’s disease is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. […] The disease initially can be managed with observation and non-surgical therapy. […] Surgical referral should be made when metacarpophalangeal joint contracture reaches 30 degrees or when proximal interphalangeal joint contracture occurs at any degree. […] Timing of surgical intervention varies, but surgery is usually performed when the metacarpophalangeal joint contracture exceeds 40 degrees or when the proximal interphalangeal joint contracture exceeds 20 degrees. […] Surgery is recommended if function is impaired, contracture is progressing, or severe deformity is disabling. […] Referral to a hand surgeon is indicated if the MCP joint contracture reaches 30 degrees or if PIP joint contracture occurs at any degree.

• #13 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  A variety of non-surgical and surgical options are available for management of Dupuytren disease (DD). The choice largely depends on the severity of disease, degree of deformity, limitations in function, and provider preference. Although there is no consensus, it is generally accepted that surgical procedures are reserved for patients with contractures 30-40 or with significant disability. […] Observation is appropriate for patients with unchanging, painless Dupuytren disease who have minimal contracture and no functional impairment. Patients with mild Dupuytren disease can be monitored on an infrequent basis via a brief follow-up visit every 6-12 months. […] Stretching with the application of heat and ultrasonographic waves may be helpful in the early stages of Dupuytren contracture. The physical therapist also may recommend that the patient wear a custom splint or brace to stretch the fingers further. Range of motion (ROM) exercises should be performed several times a day. If the patient undergoes surgical correction of the contracture, physical therapy often is involved following the procedure.

• #14 Dupuytren’s Disease – Dupuytren’s Contracture – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/dupuytrens-disease/

  Your doctor will likely talk with you about your general health and medical history and ask about your symptoms. […] Currently, there is no cure for Dupuytren’s; however, the condition is not life- or limb-threatening. […] Physical therapy can help improve strength and function in your fingers and hand, reduce swelling, and aid in wound care. Often, a hand therapist will make a splint for you to wear during recovery. […] Most patients have improved movement in their fingers after surgery. However, because the condition is not „cured” with surgery, about 20% of patients will experience a meaningful degree of contracture recurrence (the contracture comes back). Additional surgery may be required for some patients.

• #15 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  A variety of non-surgical and surgical options are available for management of Dupuytren disease (DD). The choice largely depends on the severity of disease, degree of deformity, limitations in function, and provider preference. Although there is no consensus, it is generally accepted that surgical procedures are reserved for patients with contractures 30-40 or with significant disability. […] Observation is appropriate for patients with unchanging, painless Dupuytren disease who have minimal contracture and no functional impairment. Patients with mild Dupuytren disease can be monitored on an infrequent basis via a brief follow-up visit every 6-12 months. […] Stretching with the application of heat and ultrasonographic waves may be helpful in the early stages of Dupuytren contracture. The physical therapist also may recommend that the patient wear a custom splint or brace to stretch the fingers further. Range of motion (ROM) exercises should be performed several times a day. If the patient undergoes surgical correction of the contracture, physical therapy often is involved following the procedure.

• #16 Dupuytren Contracture: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16941-dupuytrens-contracture

  Dupuytren contracture is a genetic disorder that makes the tissue under the skin of your palms and fingers thicken and tighten. Theres no cure, but symptoms take months or years to advance. There are lots of treatment options, including nonsurgical ways to relieve your symptoms. […] Your provider will treat your Dupuytren contracture in several stages, depending on how severe your symptoms are. […] Conservative treatments for Dupuytren contracture include: Physical therapy or stretching exercises. Bracing or splinting to stretch your fingers to their usual range of motion (how far you can move them). Ultrasonic (painless sound waves) or heat treatments to increase your fascias flexibility. Corticosteroid injections to shrink nodules and cords. […] Your provider may refer you to a radiation specialist to help treat Dupuytren contracture or prevent your symptoms from progressing. Radiation therapy is a painless procedure that involves using X-rays or other beams aimed at the nodules or cords to soften them.

• #17 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  A variety of non-surgical and surgical options are available for management of Dupuytren disease (DD). The choice largely depends on the severity of disease, degree of deformity, limitations in function, and provider preference. Although there is no consensus, it is generally accepted that surgical procedures are reserved for patients with contractures 30-40 or with significant disability. […] Observation is appropriate for patients with unchanging, painless Dupuytren disease who have minimal contracture and no functional impairment. Patients with mild Dupuytren disease can be monitored on an infrequent basis via a brief follow-up visit every 6-12 months. […] Stretching with the application of heat and ultrasonographic waves may be helpful in the early stages of Dupuytren contracture. The physical therapist also may recommend that the patient wear a custom splint or brace to stretch the fingers further. Range of motion (ROM) exercises should be performed several times a day. If the patient undergoes surgical correction of the contracture, physical therapy often is involved following the procedure.

• #18 Dupuytren’s contracture | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dupuytrens-contracture

  Dupuytren’s contracture is a thickening and shortening of tissue in the palm, resulting in clawed fingers as they are pulled towards the hand. […] Treatment options include injections of corticosteroids into the palm and surgery. […] Treatment depends on the severity of the condition, but may include injections of corticosteroids into the palm and surgery. […] In its earlier stages, treatment may include injections of corticosteroids into the fascia. These medications reduce any localised tenderness and may help to delay subsequent thickening of the tissue. […] Occupational therapy is needed after surgery to speed recovery and reduce the risks of the contracture returning. Techniques may include: splints worn at night for a few months to straighten the finger, sometimes, a splint worn during the day, special hand exercises to encourage flexibility, gentle massage with moisturising hand cream.

• #19

  https://www.hingehealth.com/resources/articles/dupuytrens-contracture/

  Consistency matters, says Dr. Reising. Stretching is key to maintaining the mobility in your hands, but doing it once a week is not going to be enough. Try making it a habit and a part of your daily routine like brushing your teeth. It only takes a few minutes. Aim to do the exercises at least once a day, says Dr. Reising.

• #20 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  Intralesional triamcinolone acetonide (Kenalog-40) injections of 40 mg/mL have yielded subjective improvement in the size of Dupuytren nodules in some patients. […] Radiotherapy can be effective in slowing disease progression in the early stages of Dupuytren contracture, and may even provide long-term relief of symptoms. […] Routine postoperative care is essential for an optimal outcome. Immediately following the procedure, a splint should be applied dorsally to avoid excess pressure on the incision site. […] A specific exercise regimen with an occupational therapist should be instituted with range-of-motion exercises 1 week postoperatively. A rehabilitation program is critical for successful management of these patients; it helps to reduce swelling, improve wound healing, and restore finger mobility and function.

• #21 Dupuytren’s Disease: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0701/p86.html

  Surgery is usually successful, but recurrence is common. […] Percutaneous needle aponeurotomy of the nodule is an alternative to surgery. […] A study showed that injections with tri-amcinolone acetonide (Kenalog) monthly for up to five months, or every six weeks for up to three injections, followed by a six-month respite, lead to significant disease regression. […] Surgery was needed in fewer patients who received injections than would be anticipated in patients receiving expectant management alone.

• #22 Dupuytren’s Disease / Dupuytren’s Contracture | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/hand-program/dupuytrens-contracture

  A procedure that removes the diseased tissue is called fasciectomy. This procedure is usually a very effective method of treatment. However, the recovery time can be long, especially if the skin is in bad condition and skin grafts are needed. […] The University of Michigan is also using a new FDA-approved treatment for Dupuytren’s disease: clostridial collagenase (XIAFLEX) injections that destroy the excess collagen causing the thickening and shortening of the tissue. […] Recovery time and need for physical therapy are dramatically reduced with injections compared to traditional surgical treatment. […] In select cases, the contracted, diseased tissue can be weakened by simply puncturing it with a needle multiple times through the skin. This procedure can be performed under local anesthesia and give quick results, much like Xiaflex injection.

• #23 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  Intralesional triamcinolone acetonide (Kenalog-40) injections of 40 mg/mL have yielded subjective improvement in the size of Dupuytren nodules in some patients. […] Radiotherapy can be effective in slowing disease progression in the early stages of Dupuytren contracture, and may even provide long-term relief of symptoms. […] Routine postoperative care is essential for an optimal outcome. Immediately following the procedure, a splint should be applied dorsally to avoid excess pressure on the incision site. […] A specific exercise regimen with an occupational therapist should be instituted with range-of-motion exercises 1 week postoperatively. A rehabilitation program is critical for successful management of these patients; it helps to reduce swelling, improve wound healing, and restore finger mobility and function.

• #24 Radiation Offers Hope for Patients With Dupuytren’s Contracture

  https://www.baystatehealth.org/patient-stories/radiation/elizabeth-carr

  The goal is to prevent the cording and restriction that occurs in the hand. […] It is important to understand that not all cases need treatment. […] The best results occur when the treatment is performed early in the course of the disease both in terms of length of time present and the amount of deformity. […] At Baystate, we believe in offering radiation for patients with Dupuytrens contracture after they have evaluated all available options. […] Recommendations for other common treatments for Dupuytrens contracture vary due to the severity of the disease and include steroid shots, enzyme injections, and needle aponeurotomy. […] Surgery is often used in more advanced cases where patients have limited mobility of their hand, the problem is that eventually the scar tissue and contractures may recur resulting in even more limited mobility. […] I would highly recommend considering this procedure for those with Dupuytrens contracture.

• #25 Dupuytren contracture – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dupuytrens-contracture/diagnosis-treatment/drc-20371949

  In most cases, Dupuytren contracture can be diagnosed by the look and feel of the hands. Other tests are rarely necessary. […] Treatment involves removing or breaking apart the cords that are pulling your fingers toward your palm. This can be done in several ways. The choice of procedure depends on the severity of your symptoms and other health problems you may have. […] Any treatment of Dupuytren contracture may provide only temporary relief. The contraction of the fingers often returns with time. […] If you have mild Dupuytren contracture, you can protect your hands by avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape. […] Your health care provider might send you to see a bone surgeon. This is often called a referral to an orthopedic surgeon.

• #26 Dupuytren Contracture: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16941-dupuytrens-contracture

  If your symptoms havent improved after a few months of conservative treatments, your provider might recommend needle aponeurotomy. This procedure is sometimes called a percutaneous needle fasciotomy. Needle aponeurotomy is an outpatient procedure your provider can perform in their office. […] If your contracture is so severe that it interferes with your quality of life, you might need surgery. Dupuytren contracture surgery is an outpatient procedure, which means you can go home the same day. […] Theres no cure for Dupuytren contracture. However, almost all cases are manageable with treatment. […] Follow the instructions your provider gives you to manage your Dupuytren contracture symptoms. If you have stretches to perform or need to wear a splint or brace, make sure to do so as often as your provider instructs. […] Talk to your provider before resuming any of your regular activities while youre recovering. […] If you notice your symptoms progressing (getting worse), talk to your provider. The sooner you get treatment, the more likely it is you can relieve your symptoms before they advance further.

• #27

  https://www.orthobullets.com/hand/6058/dupuytrens-disease

  Percutaneous needle aponeurotomy (PNA) is indicated for mild contractures and medical co-morbidities that preclude surgery. […] Operative treatment includes partial palmar fasciectomy for MCP and PIP flexion contractures, with postoperative care involving early active range of motion and splinting. […] Total/radical palmar fasciectomy is infrequently used and involves the release/excision of all palmar and digital fascia including non-diseased fascia. […] Rehabilitation and postoperative care involve hand therapy for several months, starting 3-5 days postoperatively, including scar and edema management.

• #28 Physical therapy in Burr Ridge & Hinsdale for Dupuytrens Contracture Surgery

  https://www.dptsport.com/Injuries-Conditions/Hand/Surgery/Dupuytrens-Contracture-Surgery-Patient-Guide/a~4515/article.html

  Rehabilitation will begin once these bandages are removed. […] Rehabilitation after a palmar fasciectomy is considerably more extensive. […] Attending the recommended physical therapy sessions can make the difference to a successful result after fasciectomy surgery. […] Our physical therapist may recommend that you wear a splint at night for up to six months after surgery. […] Generally physical therapy at DPT Sport Concierge occurs without any issues, and full recovery occurs provided our advice is closely followed.

• #29 Dupuytren’s Contracture Treatments – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/800_899/0800.html

  Surgical excision remains the most common treatment. […] The ideal treatment would be directed at patients with early progressive disease to prevent future deterioration. […] Intralesional steroid injection and radiotherapy appeared to lead to softening of nodules and to retard disease progression, but lacked rigorous evaluation and studies were poorly designed. […] Needle aponeurotomy should be the first option treatment. […] This minimally invasive out-patient procedure minimizes sick leave and does not require immobilization or physical therapy. […] The authors concluded that this study demonstrated that treating patients with DC by injection with CCH generated a total savings of 29 % and 51 % (388 and 1008) compared with fasciectomy at the time of treatment. […] The authors concluded that treatment of DC with 1 CCH injection cost 33 % less than FSC with equivalent effectiveness at 6 weeks regarding reduction in contracture.

• #30 Dupuytren’s Disease: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0701/p86.html

  Dupuytren’s disease is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. […] The disease initially can be managed with observation and non-surgical therapy. […] Surgical referral should be made when metacarpophalangeal joint contracture reaches 30 degrees or when proximal interphalangeal joint contracture occurs at any degree. […] Timing of surgical intervention varies, but surgery is usually performed when the metacarpophalangeal joint contracture exceeds 40 degrees or when the proximal interphalangeal joint contracture exceeds 20 degrees. […] Surgery is recommended if function is impaired, contracture is progressing, or severe deformity is disabling. […] Referral to a hand surgeon is indicated if the MCP joint contracture reaches 30 degrees or if PIP joint contracture occurs at any degree.

• #31 Dupuytren’s Disease Treatment – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/orthopaedic-surgery/hand-and-upper-extremity/dupuytrens-disease

  If diagnosed early, symptoms of Dupuytren’s disease may be reduced without surgery. Non-surgical treatments include: Enzyme injection, a minimally invasive procedure done in an office visit and involving the injection of an enzyme solution into the cords in your hand. Over several hours to days, the enzyme breaks down and dissolves the contracted tissue. Your surgeon will snap the cords by manipulating and straightening your fingers. […] If non-surgical treatment does not relieve your symptoms, surgery may be recommended. Surgical approaches include: Fasciotomy involves making an incision in your palm through which your surgeon divides the thickened tissue. Dividing the cord helps to decrease the contracture and increase finger movement. […] Our certified hand therapists can help reduce swelling and speed your recovery through wound care, and strength and flexibility exercises. He or she will fabricate a splint for you to wear during recovery.

• #32 Patient Education | Concord Orthopaedics

  https://www.concordortho.com/patient-resources/patient-education/topic/87dd7a6db0de0c96774d9d23735f291f

  Surgery […] No hard and fast rule exists as to when surgery is needed. But the sooner a contracture is treated, the better the results of a return to full function. Surgery is usually recommended when the MCP joint (at the knuckle) of the finger reaches 30 degrees of flexion. The goal of tissue release surgery is to release the fibrous attachments between the palmar fascia and the tissues around it, thereby releasing the contracture. […] Palmar Fascia Removal (partial or limited palmar fasciectomy) […] This remains the gold standard of treatment for Dupuytren’s contracture. Removal of the diseased palmar fascia causing the contracture will usually give a very good result. Final outcomes depend a great deal on the success of doing the postoperative physical or occupational therapy as prescribed.

• #33 Dupuytren’s contracture

  https://www.nhs.uk/conditions/dupuytrens-contracture/

  Dupuytren’s contracture does not usually need any treatment in the early stages. […] If it’s severe and you cannot straighten your fingers or use your hand normally, a GP may refer you to a specialist for treatment. […] The specialist will explain what the benefits and risks of each treatment option are. They’ll tell you what to expect afterwards, including advice on exercises to do. […] Your finger may not be completely straight after treatment, and might not be as strong and flexible as it used to be. […] There are 3 main types of treatment: surgery to remove the affected tissue in the hand (fasciectomy), using a needle to make small cuts in the affected tissue (needle fasciotomy), surgery to remove the affected tissue and skin (dermofasciectomy). […] If you have Dupuytren’s contracture, you might be able to refer yourself directly to services for help with your condition without seeing a GP.

• #34 Dupuytren’s Contracture Madison, WI | Needle Aponeurotomy Milwaukee

  https://www.orthowisconsin.com/dupuytrens-contracture-orthopaedic-surgeon-wisconsin.html

  If conservative treatment options fail to resolve the condition, the symptoms persist for 6 months or more, and your quality of life is adversely affected, your surgeon may recommend a surgical procedure to open the tendon sheath and allow more room for the movement of the tendon. […] This surgery is usually performed in an operating room under local or regional anesthesia on an outpatient basis as day surgery. Your surgeon makes a small incision to the affected palm area. Your surgeon then removes the thickened fibrous tissue causing the contracture. The incision is then closed with sutures and covered with a sterile dressing.

• #35 Dupuytren’s Disease – Dupuytren’s Contracture – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/dupuytrens-disease/

  Your doctor will likely talk with you about your general health and medical history and ask about your symptoms. […] Currently, there is no cure for Dupuytren’s; however, the condition is not life- or limb-threatening. […] Physical therapy can help improve strength and function in your fingers and hand, reduce swelling, and aid in wound care. Often, a hand therapist will make a splint for you to wear during recovery. […] Most patients have improved movement in their fingers after surgery. However, because the condition is not „cured” with surgery, about 20% of patients will experience a meaningful degree of contracture recurrence (the contracture comes back). Additional surgery may be required for some patients.

• #36 Dupuytren’s contracture. Surgical principles, nursing implications – PubMed

  https://pubmed.ncbi.nlm.nih.gov/1883240/

  Successful Dupuytren’s surgery requires the cooperation of the patient, the surgeon, and the therapist. Cooperation of the patient is enhanced by nursing care. Preoperative and postoperative teaching by the nurse also contribute to positive outcomes. […] The type of incision or surgery performed does not affect the time of recovery if the diseased tissue is removed and there are no postoperative complications.

• #37 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  Intralesional triamcinolone acetonide (Kenalog-40) injections of 40 mg/mL have yielded subjective improvement in the size of Dupuytren nodules in some patients. […] Radiotherapy can be effective in slowing disease progression in the early stages of Dupuytren contracture, and may even provide long-term relief of symptoms. […] Routine postoperative care is essential for an optimal outcome. Immediately following the procedure, a splint should be applied dorsally to avoid excess pressure on the incision site. […] A specific exercise regimen with an occupational therapist should be instituted with range-of-motion exercises 1 week postoperatively. A rehabilitation program is critical for successful management of these patients; it helps to reduce swelling, improve wound healing, and restore finger mobility and function.

• #38 Aftercare after surgery | The British Dupuytren’s Society

  https://dupuytrens-society.org.uk/treatment-2/dupuytrens-disease/care-and-exercises-after-limited-fasciectomy-2/

  What to expect after Dupuytren’s surgery and what to do to get the best possible results. […] There is an app to help with post-surgical care, it can be found here, with an introduction to the app here. […] You can expect a bulky bandage covering the palm and the fingers that were operated on. […] Hold your hand high as much as possible the first 2-3 days. […] Gentle movement of all fingers is usually advised after 2-3 days this will stimulate the circulation. […] The bandage should not get wet, cover it in plastic if you are going to do anything involving water. […] As soon as the skin has healed start moisturising the scar area, to keep it soft and get a stretchy scar. […] Some swelling and stiffness is very common, especially the first few days. […] Expect reduced grip and strength for at least 2 months in that hand.

• #39 Aftercare after surgery | The British Dupuytren’s Society

  https://dupuytrens-society.org.uk/treatment-2/dupuytrens-disease/care-and-exercises-after-limited-fasciectomy-2/

  What to expect after Dupuytren’s surgery and what to do to get the best possible results. […] There is an app to help with post-surgical care, it can be found here, with an introduction to the app here. […] You can expect a bulky bandage covering the palm and the fingers that were operated on. […] Hold your hand high as much as possible the first 2-3 days. […] Gentle movement of all fingers is usually advised after 2-3 days this will stimulate the circulation. […] The bandage should not get wet, cover it in plastic if you are going to do anything involving water. […] As soon as the skin has healed start moisturising the scar area, to keep it soft and get a stretchy scar. […] Some swelling and stiffness is very common, especially the first few days. […] Expect reduced grip and strength for at least 2 months in that hand.

• #40 Aftercare after surgery | The British Dupuytren’s Society

  https://dupuytrens-society.org.uk/treatment-2/dupuytrens-disease/care-and-exercises-after-limited-fasciectomy-2/

  What to expect after Dupuytren’s surgery and what to do to get the best possible results. […] There is an app to help with post-surgical care, it can be found here, with an introduction to the app here. […] You can expect a bulky bandage covering the palm and the fingers that were operated on. […] Hold your hand high as much as possible the first 2-3 days. […] Gentle movement of all fingers is usually advised after 2-3 days this will stimulate the circulation. […] The bandage should not get wet, cover it in plastic if you are going to do anything involving water. […] As soon as the skin has healed start moisturising the scar area, to keep it soft and get a stretchy scar. […] Some swelling and stiffness is very common, especially the first few days. […] Expect reduced grip and strength for at least 2 months in that hand.

• #41 Aftercare after surgery | The British Dupuytren’s Society

  https://dupuytrens-society.org.uk/treatment-2/dupuytrens-disease/care-and-exercises-after-limited-fasciectomy-2/

  What to expect after Dupuytren’s surgery and what to do to get the best possible results. […] There is an app to help with post-surgical care, it can be found here, with an introduction to the app here. […] You can expect a bulky bandage covering the palm and the fingers that were operated on. […] Hold your hand high as much as possible the first 2-3 days. […] Gentle movement of all fingers is usually advised after 2-3 days this will stimulate the circulation. […] The bandage should not get wet, cover it in plastic if you are going to do anything involving water. […] As soon as the skin has healed start moisturising the scar area, to keep it soft and get a stretchy scar. […] Some swelling and stiffness is very common, especially the first few days. […] Expect reduced grip and strength for at least 2 months in that hand.

• #42 Dupuytren Contracture Repair (Discharge Care)

  https://www.drugs.com/cg/dupuytren-contracture-repair-discharge-care.html

  Dupuytren contracture repair is surgery to divide or remove the thickened tissue in your hand. This will help you straighten your fingers and use your hand for daily activities. […] Care for your surgery site as directed: Keep the bandage on your hand clean and dry. Your healthcare provider will tell you when it is okay to take a shower or bath. Your provider will tell you when to change the bandage. Look for signs of infection, such as red streaks, swelling, and pus. Check for infection every day. […] Go to hand or physical therapy. A hand therapist teaches you specific exercises to improve movement and strength and decrease pain.

• #43 Dupuytren Contracture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526074/

  Postoperatively, patients are entered into hand therapy to help maintain the hand’s range of motion. Extension splints often are used in conjunction with other modalities. Physical therapy should be undertaken for at least 3 months to prevent contractures. Maximal benefits of surgery are not immediate and only become obvious after 6 to 8 weeks. Commonly utilized postoperative hand rehabilitation includes regular range-of-motion exercises, scar and edema management, and dynamic vs static splints. These therapy interventions should be started after the inflammatory phase of wound healing, which usually peaks 3 5 days post-op. Effective postoperative management is thought to account for up to 50% of overall surgical outcomes, thus underscoring the importance of appropriate therapy. […] The management of Dupuytren contracture is done by an interprofessional team that may consist of a dermatologist, orthopedic/hand surgeon, hand therapist, and the patient’s primary care physician. There are multiple treatment options available. Open techniques offer more comprehensive removal of diseased tissue while directly visualizing critical neurovascular structures. Injection-based therapy has the benefit of being minimally invasive, but there is a greater risk of damage to surrounding structures and incomplete release of contractures. Recurrence of the disorder is common with all treatments but highest with non-operative and injection-based options. The follow-up of these patients is usually done by the treating surgeon and the patient’s primary care provider. The primary care physician can help the patient manage blood glucose, reduce alcohol consumption, and discontinue smoking. Only symptomatic patients with limitations in motion should be offered treatment because all treatments have potential complications. Close communication between the healthcare team is essential to improve outcomes. Hand therapists also play a pivotal role in restoring motion and treating this disease.

• #44 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  Intralesional triamcinolone acetonide (Kenalog-40) injections of 40 mg/mL have yielded subjective improvement in the size of Dupuytren nodules in some patients. […] Radiotherapy can be effective in slowing disease progression in the early stages of Dupuytren contracture, and may even provide long-term relief of symptoms. […] Routine postoperative care is essential for an optimal outcome. Immediately following the procedure, a splint should be applied dorsally to avoid excess pressure on the incision site. […] A specific exercise regimen with an occupational therapist should be instituted with range-of-motion exercises 1 week postoperatively. A rehabilitation program is critical for successful management of these patients; it helps to reduce swelling, improve wound healing, and restore finger mobility and function.

• #45 Physical therapy in Burr Ridge & Hinsdale for Dupuytrens Contracture Surgery

  https://www.dptsport.com/Injuries-Conditions/Hand/Surgery/Dupuytrens-Contracture-Surgery-Patient-Guide/a~4515/article.html

  Rehabilitation will begin once these bandages are removed. […] Rehabilitation after a palmar fasciectomy is considerably more extensive. […] Attending the recommended physical therapy sessions can make the difference to a successful result after fasciectomy surgery. […] Our physical therapist may recommend that you wear a splint at night for up to six months after surgery. […] Generally physical therapy at DPT Sport Concierge occurs without any issues, and full recovery occurs provided our advice is closely followed.

• #46

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ud1629

  Fasciectomy (say „fash-ee-EK-tuh-mee”) is surgery to cut out a layer of tissue called the fascia (say „FASH-ee-uh”) that lies deep under the skin. In Dupuytren’s (say „duh-pwee-TRAHNZ”) contracture, the fascia of the palm of the hand becomes thick and tight. This causes the fingers to become stiff and to curl toward the palm. Removing the fascia can help relax the fingers. […] An important part of recovery is hand therapy. Work with your physiotherapist or occupational therapist and practice hand exercises at home to help your fingers become more flexible. Hand therapy may also help prevent future problems. Most people need to do hand therapy for several months. You also may need to wear a hand splint for 6 to 12 weeks after surgery. […] Gently bend and straighten your fingers throughout the day to keep them flexible and to help reduce swelling.

• #47

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ud1629

  Do your hand therapy as directed by your doctor or physiotherapist or occupational therapist. This can help you regain flexibility and strength in your hand and fingers. To get the best results, you need to do the exercises correctly and as often and as long as your doctor or physiotherapist or occupational therapist tells you to.

• #48 Physical therapy in Burr Ridge & Hinsdale for Dupuytrens Contracture Surgery

  https://www.dptsport.com/Injuries-Conditions/Hand/Surgery/Dupuytrens-Contracture-Surgery-Patient-Guide/a~4515/article.html

  Rehabilitation will begin once these bandages are removed. […] Rehabilitation after a palmar fasciectomy is considerably more extensive. […] Attending the recommended physical therapy sessions can make the difference to a successful result after fasciectomy surgery. […] Our physical therapist may recommend that you wear a splint at night for up to six months after surgery. […] Generally physical therapy at DPT Sport Concierge occurs without any issues, and full recovery occurs provided our advice is closely followed.

• #49 Physical therapy in Burr Ridge & Hinsdale for Dupuytrens Contracture Surgery

  https://www.dptsport.com/Injuries-Conditions/Hand/Surgery/Dupuytrens-Contracture-Surgery-Patient-Guide/a~4515/article.html

  Rehabilitation will begin once these bandages are removed. […] Rehabilitation after a palmar fasciectomy is considerably more extensive. […] Attending the recommended physical therapy sessions can make the difference to a successful result after fasciectomy surgery. […] Our physical therapist may recommend that you wear a splint at night for up to six months after surgery. […] Generally physical therapy at DPT Sport Concierge occurs without any issues, and full recovery occurs provided our advice is closely followed.

• #50 Dupuytrens Contracture Treatment by Dr Erickson in Raleigh

  https://www.johnericksonmd.com/patient-information/dupuytrens-contracture/

  Many people with Dupuytrens have a mild form of the disease and they may not develop severe contractures in their hands. For these patients, education and observation is all that is required. Re-evaluation should be considered when you can no longer place the hand flat on a table (tabletop test) or when your lifestyle is affected. […] In more moderate or severe cases, flexion contractures can interfere with hand function. If quality of life is affected, further treatment may be recommended. There are numerous procedures which have been described to treat Dupuytrens contractures. […] After the needle (NA) or collagenase injection procedures, patients are encouraged to gently work on finger range of motion (bending and straightening the fingers) guided by therapy. These exercises are performed several times a day at home/work. Use of the hand is allowed as pain tolerates, avoiding heavy lifting for one week. The swelling and tenderness from the procedure gradually improve over a few days. The recovery is more rapid with NA or Xiaflex collagenase procedures, compared to surgery.

• #51 Dupuytren’s: Questions for and From Your Doctor

  https://www.webmd.com/a-to-z-guides/dupuytrens-disease-frequently-asked-questions

  If you or a loved one has symptoms of Dupuytren’s contracture, also known as Dupuytren’s disease, it’s important to see a health professional for a definitive diagnosis. Your health care provider can also answer your questions about Dupuytren’s, including what to expect, and available treatment options. […] Dupuytren’s contracture is generally painless, although the lumps or nodules that appear on the palm of the hand may be tender to the touch. […] After reaching a diagnosis, your health care provider will provide general information on Dupuytren’s disease, including what you can expect and possible treatment options. […] The treatment you receive will depend on the location, stage, and severity of the disorder. In your initial consultation, your doctor will probably provide a brief overview of how Dupuytren’s is treated. A newer procedure uses enzyme injections to dissolve the tissue. This is usually used first as it is least invasive. In cases where contracture has progressed, surgery is the most common treatment. Another treatment method uses needles to break up affected tissue. […] As mentioned earlier, the recurrence rate of Dupuytren’s symptoms is high, so whatever treatment you have may need to be repeated. Recurrence rates are lower after surgery than after needle or enzyme procedures.

• #52 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  A variety of non-surgical and surgical options are available for management of Dupuytren disease (DD). The choice largely depends on the severity of disease, degree of deformity, limitations in function, and provider preference. Although there is no consensus, it is generally accepted that surgical procedures are reserved for patients with contractures 30-40 or with significant disability. […] Observation is appropriate for patients with unchanging, painless Dupuytren disease who have minimal contracture and no functional impairment. Patients with mild Dupuytren disease can be monitored on an infrequent basis via a brief follow-up visit every 6-12 months. […] Stretching with the application of heat and ultrasonographic waves may be helpful in the early stages of Dupuytren contracture. The physical therapist also may recommend that the patient wear a custom splint or brace to stretch the fingers further. Range of motion (ROM) exercises should be performed several times a day. If the patient undergoes surgical correction of the contracture, physical therapy often is involved following the procedure.

• #53 Aftercare after surgery | The British Dupuytren’s Society

  https://dupuytrens-society.org.uk/treatment-2/dupuytrens-disease/care-and-exercises-after-limited-fasciectomy-2/

  Exercises may need to be done for up to 6 months. […] Please note exercising can be uncomfortable but should not be really painful. […] Any exercises where you use the other hand to push the joints are best only started when the wound has healed and any scabs have come off. […] Strengthening exercises can normally be started at 6-8 weeks post surgery. […] The use of splints is controversial, some surgeons will prescribe them, while others won’t.

• #54 Dupuytren’s Contracture | Cooper University Health Care

  https://www.cooperhealth.org/services/dupuytrens-contracture

  Dupuytren’s contracture is a progressive condition in which theres an abnormal thickening of this tissue at the base of your fingers. […] While theres no cure for Dupuytrens contracture, there are effective treatmentsboth non-surgical and surgicalthat can slow the disease or help ease your symptoms. […] If left untreated, Dupuytrens contracture may prevent you from straightening your fingers fully, interfering with your ability to use your hands for certain tasks. […] Its also important to see a specialist because the symptoms of Dupuytrens contracture can be similar to other conditions such as trigger finger or tendinitis. […] Treatment is tailored to the severity of your condition: Non-surgical injection of an enzyme called collagenase is the standard of care for most cases today. […] Surgery may be indicated in advanced cases when patients have limited use of their hands. […] If you have had surgical or non-surgical treatment for Dupuytrens contracture, wear the hand splints and do the exercises as your doctor prescribes.

• #55 How to Relieve Dupuytren’s Contracture Pain

  https://www.healthline.com/health/dupuytrens-contracture/pain-relief-for-dupuytrens-contracture

  Dupuytrens contracture is a progressive condition that affects the tissue under the skin in your palm. […] The thickened tissue can form lumps that feel tender. And the curling of the fingers can cause pain and reduce mobility. […] Theres no cure for Dupuytrens contracture. However, if the condition causes pain, itching, or discomfort, there are several treatments that may help. […] One way to make life with Dupuytrens contracture more comfortable is by using hand protection. […] Wearing padded gloves while working or doing other manual activities can help prevent pressure on your palms that could irritate nodules, grooves, or tender skin. […] Surgery is one of the most common treatments for advanced stages of Dupuytrens contracture. It can help relieve pain and restore some mobility in your hand.

• #56 Dupuytren Contracture | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions/dupuytrens-contracture

  Dupuytren contracture is an abnormal thickening of the skin in the palm of your hand at the base of your fingers. This thickened area may develop into a hard lump or thick band. Over time, it can cause one or more fingers to curl (contract), or pull sideways or in toward your palm. […] Your healthcare provider will create a care plan for you based on: Your age, overall health, and past health; How serious your case is; How well you handle certain medicines, treatments, or therapies; If your condition is expected to get worse; What you would like to do. […] There is no cure for Dupuytren contracture. The condition is not dangerous. Many people don’t get treatment. But treatment can slow the disease or help ease your symptoms. […] Treatments for Dupuytren contracture may include: Surgery. This is the most common treatment used for advanced cases. It may be done when you have limited use of your hand. […] You may have trouble using your hand for certain tasks. You may not be able to grasp large objects or straighten your fingers. […] Call your healthcare provider if your symptoms get worse or you have new symptoms. […] There is no cure, but treatment can improve symptoms.

• #57 Dupuytren’s: Questions for and From Your Doctor

  https://www.webmd.com/a-to-z-guides/dupuytrens-disease-frequently-asked-questions

  If you or a loved one has symptoms of Dupuytren’s contracture, also known as Dupuytren’s disease, it’s important to see a health professional for a definitive diagnosis. Your health care provider can also answer your questions about Dupuytren’s, including what to expect, and available treatment options. […] Dupuytren’s contracture is generally painless, although the lumps or nodules that appear on the palm of the hand may be tender to the touch. […] After reaching a diagnosis, your health care provider will provide general information on Dupuytren’s disease, including what you can expect and possible treatment options. […] The treatment you receive will depend on the location, stage, and severity of the disorder. In your initial consultation, your doctor will probably provide a brief overview of how Dupuytren’s is treated. A newer procedure uses enzyme injections to dissolve the tissue. This is usually used first as it is least invasive. In cases where contracture has progressed, surgery is the most common treatment. Another treatment method uses needles to break up affected tissue. […] As mentioned earlier, the recurrence rate of Dupuytren’s symptoms is high, so whatever treatment you have may need to be repeated. Recurrence rates are lower after surgery than after needle or enzyme procedures.

• #58 Dupuytren Contracture | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20763

  Dupuytren contracture is a benign disorder with an etiology similar to those of similar disorders such as Peyronie disease, Ledderhose disease, and Garrod disease. […] Dupuytren disease is a genetic disorder often inherited in an autosomal dominant fashion but is most frequently seen with a multifactorial etiology. […] Risk factors for increased severity and recurrence of disease after treatment include male gender, onset before age 50, bilateral disease, sibling/parent involvement, or the presence of Garrod pads, Ledderhose, or Peyronies diseases. […] Indications for treatment are based on the effects of the disease on the patient’s quality of life. Many patients with a positive tabletop test, MCP contracture of 30 degrees, or PIP contracture of 15 to 20 degrees elect to have treatment. Treatment options consist of conservative management, needle aponeurotomy, collagenase injection, or surgical resection and fasciectomy.

• #59 Dupuytrens Contracture Treatment by Dr Erickson in Raleigh

  https://www.johnericksonmd.com/patient-information/dupuytrens-contracture/

  After the fasciectomy surgery, the hand is protected in a plaster splint for the first few days. The splint is removed in clinic and hand therapy is begun. Hand therapy is very important in the recovery. This involves finger range of motion exercises, use of a splint, and daily wound care. The palm wounds typically heal within 3 weeks with this technique. A removable splint is worn at night for a few months to help prevent early recurrence. Gradual return to activities over 4-6 weeks is expected as the pain and swelling from surgery improve. […] The procedures performed for Dupuytrens contractures improve finger range of motion and hand function for many years for most patients. Patients with moderate to severe contractures of the proximal interphalangeal (PIP) joints are harder to correct. Over time, many patients develop some level of recurrence of the joint contracture. In other words, the Dupuytrens contracture can come back. Most studies report lower recurrence rates with surgery than the minimally-invasive techniques such as Xiaflex and NA.

• #60 Radiation Offers Hope for Patients With Dupuytren’s Contracture

  https://www.baystatehealth.org/patient-stories/radiation/elizabeth-carr

  Dupuytrens contracture affects about 5% of Americans who cant completely straighten some of their fingers, complicating everyday activities such as writing, throwing a baseball, golfing, or even preparing your own meal. […] The disease is a condition in which thickened, scar-like tissue forces several fingers to flex forward, caused by the development of a fibrous connection between the finger tendons and the skin of the palm. […] Dupuytrens contracture often first occurs in only one hand, affecting the right hand twice as often as the left. […] My doctor left it up to me to decide what course of action to take. […] I began to do my research to learn more about the disease and its treatments, of which surgery is just one of the options today. […] Low dose radiation therapy for Dupuytrens contracture, more often performed in Europe than America, works by reducing the inflammation and growth component of the process.

• #61 Dupuytren Contracture | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions/dupuytrens-contracture

  Dupuytren contracture is an abnormal thickening of the skin in the palm of your hand at the base of your fingers. This thickened area may develop into a hard lump or thick band. Over time, it can cause one or more fingers to curl (contract), or pull sideways or in toward your palm. […] Your healthcare provider will create a care plan for you based on: Your age, overall health, and past health; How serious your case is; How well you handle certain medicines, treatments, or therapies; If your condition is expected to get worse; What you would like to do. […] There is no cure for Dupuytren contracture. The condition is not dangerous. Many people don’t get treatment. But treatment can slow the disease or help ease your symptoms. […] Treatments for Dupuytren contracture may include: Surgery. This is the most common treatment used for advanced cases. It may be done when you have limited use of your hand. […] You may have trouble using your hand for certain tasks. You may not be able to grasp large objects or straighten your fingers. […] Call your healthcare provider if your symptoms get worse or you have new symptoms. […] There is no cure, but treatment can improve symptoms.

• #62 Dupuytren’s Contracture Causes & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/dupuytren-contracture

  Complications of Dupuytren’s contracture may include: […] Reduced freedom of hand movement: Dupuytren’s contracture can limit ones ability to fully open the affected hand, grasp large objects or maneuver the hand into narrow places. The ability to perform day-to-day tasks, such as washing dishes or grasping tools, can be decreased.

• #63 Facts on Hand: Dupuytren’s Contracture

  https://www.factsonhand.com/

  Dupuytrens contracture may be a lifelong condition. A contracture will not get straighter without treatment and may come back even if treated. […] Contractures can impact how you use your hands. […] Contractures can get more severe over time (progressive) as collagen builds up. This may impact daily activities, like texting, driving, opening jars, shaking hands, and putting on gloves. […] You dont have to wait for Dupuytrens contracture to limit the use of your hand before looking into treatment. See a Hand Specialist as soon as you notice changes in your hand. […] Dupuytrens contracture is treatable without surgery. There are minimally invasive, in-office procedures available. Not all Hand Specialists offer nonsurgical treatments, so its important to find a Hand Specialist who understands your needs. […] The right doctor will take your lifestyle, recovery preferences, and medical history into account when treating Dupuytrens contracture. If you think nonsurgical treatment is right for you but your Hand Specialist doesnt offer it, get a second opinionthere are Hand Specialists who will listen.

• #64 Dupuytren’s disease

  https://www.bssh.ac.uk/patients/conditions/25/dupuytrens_disease

  Dupuytren’s disease (also referred to as Dupuytren’s contracture) is a common condition that usually arises in middle age or later and is more common in men than women. Firm nodules appear in the ligaments just beneath the skin of the palm of the hand, and in some cases they extend to form cords that can prevent the finger straightening completely. […] Dupuytren’s disease begins with nodules in the palm, often in line with the ring finger. The nodules are sometimes uncomfortable on pressure in the early stages, but the discomfort almost always improves over time. In about one affected person out of every three, the nodules extend to form cords that pull the finger towards the palm and prevent it straightening fully. Without treatment, one or more fingers may become fixed in a bent position.

• #65 Dupuytren’s Contracture: 10 Things Doctors Want You to Know

  https://resources.healthgrades.com/right-care/bones-joints-and-muscles/dupuytrens-contracture-10-things-doctors-want-you-to-know

  Dupuytren’s contracture typically hits the ring finger first, with the pinky finger a close second, says Dr. Keith Raskin, a hand surgeon in private practice in Manhattan. As it advances, „there’s a host of problems that could occur,” says Dr. Raskin, including being unable to type, put on gloves or „wash your face without poking yourself in the eye.” Musicians can’t play their instruments, while grandparents are afraid to hold their grandbabies, adds Dr. Gary Pess, a hand surgeon who practices in New Jersey. „Even just clapping or shaking hands” becomes difficult, Dr. Pess says. […] Dupuytren is often described as a painless problem, says Dr. Eaton. „Yet it’s not.” About 25% of people with early Dupuytren disease experience pain or discomfort, says Dr. Eaton. This happens in the early stages, before bent fingers occur. „Before they have Dupuytren’s contractures, they’ll have tenderness or burning or itching or stinging in the areas involved,” such as the palm of the hand, Dr. Eaton says. Some people will develop „weird itching in their palm” so severe that it keeps them up at night, he says, while others have such painful palms that they’ll have trouble gripping things.

• #66 Dupuytren’s Contracture

  https://sportmed.com/dupuytrens-contracture/

  What Is Dupuytrens Contracture? Dupuytrens contracture is a condition where one or more fingers bend toward the palm of a persons right or left hand. No matter how hard you try, you cant get the affected fingers to straighten completely. This disease affects the palmar fascia, which is the fibrous layer of tissue that lies just underneath your palms skin, above the tendons, nerves, and blood vessels. Knots of tissue form under the skin. Eventually these knots create a thick cord, which pulls the fingers into a bent position. In almost all cases, this condition affects the two fingers farthest from your thumb. […] Unfortunately, the disease tends to worsen with the passage of time but may remain mild enough, so you dont require any treatment. However, in moderate or severe cases, the disease makes it difficult to straighten the digits. If this is the case, treatment may be necessary to assist in reducing the contracture and improving motion in the affected fingers. Please note, as contraction progresses, involvement of the fascia will become more severe, and treatment is not as likely to deliver a successful result.

• #67 Dupuytren’s Contracture | Summit Orthopedics

  https://www.summitortho.com/find-care/services-conditions/hand-and-wrist-care/hand-wrist-related-conditions-treatments/dupuytrens-contracture/

  Your custom treatment plan may include: Hand therapy: This type of physical therapy involves learning new techniques to move your hand to improve functioning. Dupuytrens contracture therapy exercises will be taught to you by a physical therapist, and you will continue those exercises at home. […] In more advanced cases, though, surgery can successfully: Relieve tension of contractures, Remove abnormal tissue from the palm and fingers, Restore a normal aesthetic appearance. […] Although treatment can help relieve some symptoms, Dupuytrens contracture is a progressive disease that often comes back even after surgery.

• #68 Dupuytren’s: Questions for and From Your Doctor

  https://www.webmd.com/a-to-z-guides/dupuytrens-disease-frequently-asked-questions

  If you or a loved one has symptoms of Dupuytren’s contracture, also known as Dupuytren’s disease, it’s important to see a health professional for a definitive diagnosis. Your health care provider can also answer your questions about Dupuytren’s, including what to expect, and available treatment options. […] Dupuytren’s contracture is generally painless, although the lumps or nodules that appear on the palm of the hand may be tender to the touch. […] After reaching a diagnosis, your health care provider will provide general information on Dupuytren’s disease, including what you can expect and possible treatment options. […] The treatment you receive will depend on the location, stage, and severity of the disorder. In your initial consultation, your doctor will probably provide a brief overview of how Dupuytren’s is treated. A newer procedure uses enzyme injections to dissolve the tissue. This is usually used first as it is least invasive. In cases where contracture has progressed, surgery is the most common treatment. Another treatment method uses needles to break up affected tissue. […] As mentioned earlier, the recurrence rate of Dupuytren’s symptoms is high, so whatever treatment you have may need to be repeated. Recurrence rates are lower after surgery than after needle or enzyme procedures.

• #69 Dupuytren’s Contracture: 10 Things Doctors Want You to Know

  https://resources.healthgrades.com/right-care/bones-joints-and-muscles/dupuytrens-contracture-10-things-doctors-want-you-to-know

  Dupuytren’s contracture typically hits the ring finger first, with the pinky finger a close second, says Dr. Keith Raskin, a hand surgeon in private practice in Manhattan. As it advances, „there’s a host of problems that could occur,” says Dr. Raskin, including being unable to type, put on gloves or „wash your face without poking yourself in the eye.” Musicians can’t play their instruments, while grandparents are afraid to hold their grandbabies, adds Dr. Gary Pess, a hand surgeon who practices in New Jersey. „Even just clapping or shaking hands” becomes difficult, Dr. Pess says. […] Dupuytren is often described as a painless problem, says Dr. Eaton. „Yet it’s not.” About 25% of people with early Dupuytren disease experience pain or discomfort, says Dr. Eaton. This happens in the early stages, before bent fingers occur. „Before they have Dupuytren’s contractures, they’ll have tenderness or burning or itching or stinging in the areas involved,” such as the palm of the hand, Dr. Eaton says. Some people will develop „weird itching in their palm” so severe that it keeps them up at night, he says, while others have such painful palms that they’ll have trouble gripping things.

• #70 Dupuytren Contracture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526074/

  Postoperatively, patients are entered into hand therapy to help maintain the hand’s range of motion. Extension splints often are used in conjunction with other modalities. Physical therapy should be undertaken for at least 3 months to prevent contractures. Maximal benefits of surgery are not immediate and only become obvious after 6 to 8 weeks. Commonly utilized postoperative hand rehabilitation includes regular range-of-motion exercises, scar and edema management, and dynamic vs static splints. These therapy interventions should be started after the inflammatory phase of wound healing, which usually peaks 3 5 days post-op. Effective postoperative management is thought to account for up to 50% of overall surgical outcomes, thus underscoring the importance of appropriate therapy. […] The management of Dupuytren contracture is done by an interprofessional team that may consist of a dermatologist, orthopedic/hand surgeon, hand therapist, and the patient’s primary care physician. There are multiple treatment options available. Open techniques offer more comprehensive removal of diseased tissue while directly visualizing critical neurovascular structures. Injection-based therapy has the benefit of being minimally invasive, but there is a greater risk of damage to surrounding structures and incomplete release of contractures. Recurrence of the disorder is common with all treatments but highest with non-operative and injection-based options. The follow-up of these patients is usually done by the treating surgeon and the patient’s primary care provider. The primary care physician can help the patient manage blood glucose, reduce alcohol consumption, and discontinue smoking. Only symptomatic patients with limitations in motion should be offered treatment because all treatments have potential complications. Close communication between the healthcare team is essential to improve outcomes. Hand therapists also play a pivotal role in restoring motion and treating this disease.

• #71 Dupuytren Contracture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526074/

  Postoperatively, patients are entered into hand therapy to help maintain the hand’s range of motion. Extension splints often are used in conjunction with other modalities. Physical therapy should be undertaken for at least 3 months to prevent contractures. Maximal benefits of surgery are not immediate and only become obvious after 6 to 8 weeks. Commonly utilized postoperative hand rehabilitation includes regular range-of-motion exercises, scar and edema management, and dynamic vs static splints. These therapy interventions should be started after the inflammatory phase of wound healing, which usually peaks 3 5 days post-op. Effective postoperative management is thought to account for up to 50% of overall surgical outcomes, thus underscoring the importance of appropriate therapy. […] The management of Dupuytren contracture is done by an interprofessional team that may consist of a dermatologist, orthopedic/hand surgeon, hand therapist, and the patient’s primary care physician. There are multiple treatment options available. Open techniques offer more comprehensive removal of diseased tissue while directly visualizing critical neurovascular structures. Injection-based therapy has the benefit of being minimally invasive, but there is a greater risk of damage to surrounding structures and incomplete release of contractures. Recurrence of the disorder is common with all treatments but highest with non-operative and injection-based options. The follow-up of these patients is usually done by the treating surgeon and the patient’s primary care provider. The primary care physician can help the patient manage blood glucose, reduce alcohol consumption, and discontinue smoking. Only symptomatic patients with limitations in motion should be offered treatment because all treatments have potential complications. Close communication between the healthcare team is essential to improve outcomes. Hand therapists also play a pivotal role in restoring motion and treating this disease.

• #72 Dupuytren’s Disease Treatment – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/orthopaedic-surgery/hand-and-upper-extremity/dupuytrens-disease

  If diagnosed early, symptoms of Dupuytren’s disease may be reduced without surgery. Non-surgical treatments include: Enzyme injection, a minimally invasive procedure done in an office visit and involving the injection of an enzyme solution into the cords in your hand. Over several hours to days, the enzyme breaks down and dissolves the contracted tissue. Your surgeon will snap the cords by manipulating and straightening your fingers. […] If non-surgical treatment does not relieve your symptoms, surgery may be recommended. Surgical approaches include: Fasciotomy involves making an incision in your palm through which your surgeon divides the thickened tissue. Dividing the cord helps to decrease the contracture and increase finger movement. […] Our certified hand therapists can help reduce swelling and speed your recovery through wound care, and strength and flexibility exercises. He or she will fabricate a splint for you to wear during recovery.

• #73 Dupuytren Contracture | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions/dupuytrens-contracture

  Dupuytren contracture is an abnormal thickening of the skin in the palm of your hand at the base of your fingers. This thickened area may develop into a hard lump or thick band. Over time, it can cause one or more fingers to curl (contract), or pull sideways or in toward your palm. […] Your healthcare provider will create a care plan for you based on: Your age, overall health, and past health; How serious your case is; How well you handle certain medicines, treatments, or therapies; If your condition is expected to get worse; What you would like to do. […] There is no cure for Dupuytren contracture. The condition is not dangerous. Many people don’t get treatment. But treatment can slow the disease or help ease your symptoms. […] Treatments for Dupuytren contracture may include: Surgery. This is the most common treatment used for advanced cases. It may be done when you have limited use of your hand. […] You may have trouble using your hand for certain tasks. You may not be able to grasp large objects or straighten your fingers. […] Call your healthcare provider if your symptoms get worse or you have new symptoms. […] There is no cure, but treatment can improve symptoms.

• #74 Restore Hand Function with Dupuytren’s Contracture Treatment | New York, NY

  https://www.shouldersandknees.com/blog/restore-hand-function-with-dupuytrens-contracture-treatment/

  Dupuytrens contracture is a progressive condition that can significantly affect the function of the hand, making daily tasks difficult or impossible. […] At Steven Struhl, MD Shoulders Knees in NYC and Westchester, we offer advanced treatments to restore hand function and improve the quality of life for patients with Dupuytrens contracture. […] In severe cases, hand function is significantly impaired, making simple actions like shaking hands, typing, or holding objects challenging. […] Although there is no cure for Dupuytrens contracture, a range of treatments can slow its progression and restore hand function. […] For early-stage Dupuytrens contracture, non-surgical options may help manage symptoms: […] When the condition progresses to the point of finger contracture, surgical intervention is often necessary. […] Both procedures aim to alleviate symptoms, restore dexterity, and prevent further complications. […] If youre experiencing symptoms of Dupuytrens contracture, early intervention can make a significant difference.

• #75 Dupuytren Contracture Treatment & Management: Approach Considerations, Rehabilitation, Collagenase Injection

  https://emedicine.medscape.com/article/329414-treatment

  A variety of non-surgical and surgical options are available for management of Dupuytren disease (DD). The choice largely depends on the severity of disease, degree of deformity, limitations in function, and provider preference. Although there is no consensus, it is generally accepted that surgical procedures are reserved for patients with contractures 30-40 or with significant disability. […] Observation is appropriate for patients with unchanging, painless Dupuytren disease who have minimal contracture and no functional impairment. Patients with mild Dupuytren disease can be monitored on an infrequent basis via a brief follow-up visit every 6-12 months. […] Stretching with the application of heat and ultrasonographic waves may be helpful in the early stages of Dupuytren contracture. The physical therapist also may recommend that the patient wear a custom splint or brace to stretch the fingers further. Range of motion (ROM) exercises should be performed several times a day. If the patient undergoes surgical correction of the contracture, physical therapy often is involved following the procedure.

• #76 Dupuytren’s Disease: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0701/p86.html

  Dupuytren’s disease is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. […] The disease initially can be managed with observation and non-surgical therapy. […] Surgical referral should be made when metacarpophalangeal joint contracture reaches 30 degrees or when proximal interphalangeal joint contracture occurs at any degree. […] Timing of surgical intervention varies, but surgery is usually performed when the metacarpophalangeal joint contracture exceeds 40 degrees or when the proximal interphalangeal joint contracture exceeds 20 degrees. […] Surgery is recommended if function is impaired, contracture is progressing, or severe deformity is disabling. […] Referral to a hand surgeon is indicated if the MCP joint contracture reaches 30 degrees or if PIP joint contracture occurs at any degree.

• #77

  https://www.hingehealth.com/resources/articles/dupuytrens-contracture/

  Consistency matters, says Dr. Reising. Stretching is key to maintaining the mobility in your hands, but doing it once a week is not going to be enough. Try making it a habit and a part of your daily routine like brushing your teeth. It only takes a few minutes. Aim to do the exercises at least once a day, says Dr. Reising.

• #78 Dupuytren’s Contracture | Cooper University Health Care

  https://www.cooperhealth.org/services/dupuytrens-contracture

  Dupuytren’s contracture is a progressive condition in which theres an abnormal thickening of this tissue at the base of your fingers. […] While theres no cure for Dupuytrens contracture, there are effective treatmentsboth non-surgical and surgicalthat can slow the disease or help ease your symptoms. […] If left untreated, Dupuytrens contracture may prevent you from straightening your fingers fully, interfering with your ability to use your hands for certain tasks. […] Its also important to see a specialist because the symptoms of Dupuytrens contracture can be similar to other conditions such as trigger finger or tendinitis. […] Treatment is tailored to the severity of your condition: Non-surgical injection of an enzyme called collagenase is the standard of care for most cases today. […] Surgery may be indicated in advanced cases when patients have limited use of their hands. […] If you have had surgical or non-surgical treatment for Dupuytrens contracture, wear the hand splints and do the exercises as your doctor prescribes.

• #79 Dupuytren contracture – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dupuytrens-contracture/diagnosis-treatment/drc-20371949

  In most cases, Dupuytren contracture can be diagnosed by the look and feel of the hands. Other tests are rarely necessary. […] Treatment involves removing or breaking apart the cords that are pulling your fingers toward your palm. This can be done in several ways. The choice of procedure depends on the severity of your symptoms and other health problems you may have. […] Any treatment of Dupuytren contracture may provide only temporary relief. The contraction of the fingers often returns with time. […] If you have mild Dupuytren contracture, you can protect your hands by avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape. […] Your health care provider might send you to see a bone surgeon. This is often called a referral to an orthopedic surgeon.

• #80 Dupuytren Contracture | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions/dupuytrens-contracture

  Dupuytren contracture is an abnormal thickening of the skin in the palm of your hand at the base of your fingers. This thickened area may develop into a hard lump or thick band. Over time, it can cause one or more fingers to curl (contract), or pull sideways or in toward your palm. […] Your healthcare provider will create a care plan for you based on: Your age, overall health, and past health; How serious your case is; How well you handle certain medicines, treatments, or therapies; If your condition is expected to get worse; What you would like to do. […] There is no cure for Dupuytren contracture. The condition is not dangerous. Many people don’t get treatment. But treatment can slow the disease or help ease your symptoms. […] Treatments for Dupuytren contracture may include: Surgery. This is the most common treatment used for advanced cases. It may be done when you have limited use of your hand. […] You may have trouble using your hand for certain tasks. You may not be able to grasp large objects or straighten your fingers. […] Call your healthcare provider if your symptoms get worse or you have new symptoms. […] There is no cure, but treatment can improve symptoms.

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