Dupuytren Contracture is a slowly progressive disease that affects the fibrous tissue under the skin of the palm and fingers, causing an abnormal buildup of collagen. Early changes appear as small nodules on the palm. This is commonly a painless disease. However, studies of this early phase have discovered that Dupuytren’s may affect the nerves in the hand and cause some pain.
As the disease progresses, this buildup causes the development of thick, ropey cords that run from the palm to the fingers. Over time, these cords contract and shorten, pulling the fingers into the palm. The ring finger is first to be affected, then the baby finger, and sometimes the middle finger in more severe cases. Nodules and bands of thickened tissue are often visible and can affect both hands leading to disability.
Patients suffering from this disease have difficulty doing daily activities including grasping an object, washing their hands, shaking hands or putting their hands in their pockets. When measurements over time show that the disease is progressing, surgery may be recommended. There is no cure, however nonsurgical treatments, including physical therapy and steroid injections, can provide improvement. Limited and percutaneous releases, called fasciotomies, can release the cords when the disease results in limited hand function.
Another treatment option includes enzyme injections. XIAFLEX®, approved by the FDA in 2010. Treatments with XIAFLEX break down and dissolve the cord that is the cause of the contraction. Patients should discuss potential treatment with this powerful medication and side effects with their doctors at SCOS.
Men are more likely to develop this disease, and it is also more severe in men than in women. It usually affects people over the age of 40, and is often more severe when it occurs at a younger age. There is evidence that this is an inherited condition. Studies are ongoing to discover the cause and to date, there is no cure.
Sometimes the symptoms of Dupuytren Contracture can resemble other diseases like arthritis or trigger finger. Nodules can be from other causes like a ganglion cyst or De Quervain’s tendonitis. Therefore, it is important to have a consultation with the hand surgeons at South County Orthopedic Specialists (SCOS). Both Dr. Kyle W. Coker and Dr. Lonnie Moskow are Board Certified by the American Board of Orthopaedic Surgery and hold specialty certifications in hand and wrist surgery. They will discuss a patient’s medical and family history and conduct a physical exam during a consultation. Imaging studies may be necessary in obtaining a correct diagnosis. After obtaining a diagnosis, the doctors at SCOS will discuss the most appropriate method to treat this disease based on each patient’s stage and pattern of the disease and whether it affects the joints.
Our goal is to provide our patients with excellent diagnostic and surgical skills and expertise as well as the compassionate care so important to both physician and patient satisfaction. At SCOS, we offer the full gamut of treatment options for Dupuytren’s contracture including percutaneous fasciotomies limited fasciotomies and Xiaflex injections, which are all performed in the office. We also specialize in the open treatment for severe Dupuytren’s contracture performed in an outpatient surgery setting and provide hand therapy in the office so that there is a close collaboration with the entire postoperative treatment.
Hand & Wrist Specialists
Lonnie Moskow, MD
He fellowship trained in hand and microvascular surgery at Sydney Hospital Hand Center, world-renowned center for hand surgery, in Sydney, Australia. Read Dr. Moskow’s biography.
Kyle Coker, MD
Dr. Coker limits his practice principally to treatment of the hand and upper extremity at South County Orthopaedic Specialists. Read Dr. Coker’s biography.