If you have fingers that bend into your palm and don’t naturally straighten, you probably have a condition called Dupuytren’s contracture or Dupuytren’s disease. Your bent fingers may be mild at first, but this disease gets progressively worse. Prompt treatment from John Hand, MD, and Brian Schofield, MD, at Schofield, Hand and Bright Orthopaedics in Sarasota, Florida, can help slow down progressive changes and improve finger movement. If you discover that you can’t straighten your fingers, don’t wait to schedule an appointment. Call the office or book online today.
You have a layer of fibrous tissue called the fascia that runs underneath the skin of your palm and fingers. When the fascia thickens and tightens, it pulls one or more fingers in toward your palm.
The ring and small fingers are most often affected by Dupuytren’s. In most cases, the disease affects both hands, but the extent of the problem can vary between hands.
Bent fingers are the obvious symptom, but you will also develop signs that often occur before you notice the problem in your fingers. As the fascia tightens, it develops into visible cords that run from your palm into one or more fingers.
Additionally, lumps appear that stick to your skin and feel firm. At first, the lumps may feel tender, but most people find that this condition is generally not painful. Over time, the lumps enlarge and pits develop in your palm.
As the condition gets worse, it gets harder to straighten your fingers. In advanced cases, bent fingers make it hard or impossible to use your hand and perform normal daily tasks.
In the early stages when your symptoms are mild, Dr. Hand may recommend closely monitoring the condition. Dupuytren’s progresses at a different pace in each person. For some, the progression is slow and their condition may not get bad enough to need treatment.
In moderate-to-severe cases of bent fingers, you may need an injection of steroids or an advanced treatment using Xiaflex®, an injectable enzyme that breaks down the tissues. Dr. Hand may recommend a surgical procedure such as fasciotomy or subtotal palmar fasciectomy.
During a fasciotomy, Dr. Hand surgically divides the thickened cords of fascia but leaves the cord in your hand. Dividing the cord relaxes your fingers and improves movement.
If you have a subtotal palmar fasciectomy, Dr. Hand removes as much of the thickened tissues as possible. He may leave the wound open to heal naturally or use a skin graft to promote healing.
Bent fingers can eventually return after any type of treatment. Dr. Hand talks with you about realistic goals and the best treatment for your disease.
If you have questions about your bent fingers, call Schofield, Hand and Bright Orthopaedics or book an appointment online today.