If one or more of your fingers involuntarily contracts and pulls inward towards your palm, you may suffer from a condition called Dupuytren's contracture. This condition is from a gradual thickening and tightening of the tissue in your hand, which creates thick nodules that pull fingers into bent positions.
Dupuytren's contracture can cause itching and pain - especially if you already have a pre-existing condition, like arthritis. Even if this condition doesn't cause pain, it can hinder everyday activities, like typing on a keyboard, holding objects, or shaking someone's hand.
You'll want to visit a doctor for a firm diagnosis. In the meantime, learn more about this condition and how to treat it.
What Causes Palm Tissue to Thicken?
Unfortunately, doctors aren't quite sure what causes Dupuytren's contracture, but some
studies
have shown that it can be prevalent in people whose occupations involve a lot of manual labor, such as the construction industry.
Even if you have no occupational risk, other factors can increase your risk of developing Dupuytren's contracture. For instance, males over the age of fifty - especially those with Northern European ancestry - are more likely to develop this condition. If you use tobacco products or drink a lot of alcohol, this can also affect blood vessels in your hand, which could lead to the condition.
Is Dupuytren's Contracture Just Another Name for Trigger Finger?
While Dupuytren's contracture and trigger finger (stenosing tenosynovitis) cause very similar symptoms of locking, bent fingers, they are not the same condition.
In trigger finger, the tendon sheaths in the fingers become swollen so that the tendons inside cannot glide smoothly. In Dupuytren's contracture, the fingers themselves aren't the root problem; your palm fascia - the protective barrier between your skin and tendons - is so thick that it draws fingers inward.
In trigger finger, you can manually unlock and bend the fingers back up. With Dupuytren's contracture, straightening the fingers may be difficult or impossible even with the help of your other hand.
Again, you'll want to visit a doctor for the correct diagnosis so that you can get the help you need. While mild cases of trigger finger may correct themselves as inflammation subsides, Dupuytren's typically needs more intervention.
How Can a Plastic Surgeon Help?
In the past, surgery used to be the only option to correct Dupuytren's contracture. However, some people may not need surgery today and may be good candidates for injectable enzymes. Enzymes are biological catalysts (usually a protein) that speed up chemical reactions.
The enzymatic injectable Xiaflex fixes Dupuytren's contracture by softening tissue and quickly breaking down taut bands of collagen in your palm. Some side effects may happen from injectables, such as edema, itching, and bruising. However, allergic reactions to this type of injectable are very rare.
If an enzyme injection isn't viable for your situation, your doctor may use a steroid injection. Steroids are anti-inflammatory medications that can reduce pain and swelling in your palm and allow fingers to relax.
Some doctors can use a needling technique to puncture and break up tight fascia. This can be a good option since you wouldn't require a deep incision from surgery or drugs if you're sensitive to medication.
If you have too much thickened palmar tissue and nodules, your doctor may recommend surgery to remove the tissue. This type of surgery would require you to be under general anesthesia, and you'd have to wear a splint afterward until you'd healed. In severe cases, where a lot of palmar tissue is too thick and needs removing, your doctor may use a skin graft to cover the wound.
Many options are available to effectively treat Dupuytren's contracture. Reach out to
Ronald C. Barry, MD, for more information on hand injections and surgery.
