Dupuytren’s Contracture is a deformity of the palms in which the fingers become irreversibly flexed, thereby limiting useful function of the hand(s). The connective tissue around the tendons, which course through the palms and fingers allowing one to bend the fingers, becomes thickened and hard to the touch. This causes a contraction or pulling the affected finger(s) into a bent position resulting in an inability to lay the hand flat against a surface. The middle, ring and little fingers are most commonly affected; however, it can affect any one of them or even the thumb. A similar condition can occur on the feet and presents as a thickened area or lump usually in the arch of the foot.
The cause is unknown. The middle-aged and elderly are most commonly affected. People who smoke or drink alcohol excessively, or who have diabetes are at an increased risk for Dupuytren’s Contracture.
Early treatment is very effective and can prevent deformity and loss of function. Dr. Parnell has been treating Dupuytren’s contracture with intralesional steroids since the mid-1980’s with invariable success. We do not know of a single patient among many hundreds treated who have progressed and required surgery. The thickened, hard knots around the tendons soften with treatment. Disease progression can be halted even when contractures have occurred.
Once contractures have occurred, they may be treated with collagenase and surgical release. This costs in the vicinity of $5,000 per hand and is not always satisfactory. Therefore, it is best to opt for early treatment.