How Is Dupuytren’s Contracture Treated?
Everyday Health discusses available treatments of Dupuytren’s contracture according to HSS hand and upper extremity surgeon Daniel A. Osei, MD, MSc and others.
Patients who only have some bumps in the hand that aren't causing discomfort or interfering with daily activity, may not require treatment according to the American Academy of Orthopaedic Surgeons (AAOS). However, patients who are unable to lay their hand flat on a table, will likely need to be treated, noted Dr. Osei.
Enzyme injections are a nonsurgical treatment option that can lead to faster recovery and possibly better control of the disease. An enzyme called collagenase clostridium histolyticum is injected into the cord in the palm to soften and weaken it. “The enzyme works by breaking down the cord,” explained Dr. Osei. The patient then comes back to their physician’s office a day or two later, at which point the physician will move the hand to break the cord, enabling the patient to straighten their fingers. While there is a lower risk of complications compared to surgery, depending on the location of the contracture, there may be a greater risk of injuring a nerve or blood vessel in your fingers, noted Dr. Osei.
Needle aponeurotomy is another nonsurgical outpatient treatment, which the patient receives an injection of anesthetic in the area with the Dupuytren’s cord. A physician then takes a small needle and perforates the cord so it can snap, allowing the fingers to straighten. “This is much like breaking up a rope with a jagged rock,” explained Dr. Osei.
A physician will gauge whether a patient should be treated with surgery based on how serious the Dupuytren’s contracture is. “To me, the severity of the contracture is the biggest criteria,” said Dr. Osei. Everyone heals differently, and some may experience more swelling or discomfort than others, but by 8 weeks post-surgery, the majority of patients are able to do most activities, he added.
Read the full article at Everydayhealth.com.