Dupuytren’s Contracture

Dr Dilley has a special interest in the treatment of Dupuytren’s Contracture.

Also known as Dupuytren’s Disease, Viking’s Disease, Celtic Hand or Palmar Fibromatosis, this is a hand condition in which the tissue  under the skin of the palm thickens and may contract so  pulling the fingers into the palm.

• A small nodule on the palm. 
• This may progress to form a cordlike growth on the palm, and finally, permanent contracture of the fingers (usually the ring and small fingers). 
• Skin pitting and dimpling may also be present.  
• Tasks such as shaking hands, washing your face, holding large objects or reaching into pockets may become difficult.  
• There is an inability to lay the hand flat on the table (tabletop test)  
• It generally appears in one hand first, and sometimes appears in the other hand later, but not always. 
• Hand therapy or cortisone injections do not generally improve the condition but generally it is not painful.

How common is Dupuytren’s Contracture?

• The incidence of Dupuytren varies from study to study
• The more severe form of the condition (finger contracture) tends to occur in men.

• Gender and aging are the most significant risk factors along with family history. 
• People of northern European backgrounds are more at risk 
• Medical triggers sometimes include thyroid disease, some epilepsy medications, pre-existing hand conditions, people with a high fasting blood glucose level, diabetes.

Typically trigger finger shows up in the thumb and ring finger, but can happen to other fingers. The fingers struggle to bend and feel locked in either a bent or straight position and open with a snap, or “trigger”.

This is a procedure to straighten fingers that have become bent, and this procedure can also be called a percutaneous needle fasciotomy (PNF).

During the procedure, your hand will be numbed with a local anaesthetic, and a thin needle will be inserted to separate and perforate the thickened cord. 

No stitches will be required but you will be encouraged to wear a splint, at night,  for about six weeks. You can use your hand during the day.

Dr Dilley performs this procedure in his Harris Park rooms on each alternate Tuesday as an outpatient procedure so you go home on the same day.

• This will be discussed at the time of your appointment.