Dupuytren’s Contracture develops in hands and feet. It most commonly affects the 4th and 5th fingers. The skin progressively thickens and becomes cord-like. As the disease progresses it bends the finger joints permanently into contractures.
Though it is more common in the west as compared to the Indian subcontinent we do get patients suffering from this disease. Progressive deformity makes it difficult for the patients to work properly. It hinders their day-to-day activities.
Risk factors for developing Dupuytren's contracture include
1) Male gender: Male patients are more prone to having this disease than females
2) Diabetes: Diabetics are more prone than non-diabetics.
3) People using Vibratory instruments are at more risk.
4) Tobacco and alcohol consumption is also risk factor.
1) Needle / closed fasciotomy
2) Open fasciectomy with SSG
3) Multiple Z plasty
4) Non-surgical enzyme and steroid injections
Treatment of Dupuytren's disease is dependent on the severity of the disease. Early cases with 15-30 degrees of deformity may be treated with minimally invasive needle fasciotomy or closed fasciotomy. The more extensive disease needs open fasciectomy or Z-plasty for treatment.
Some patients who are not fit for surgery may opt for non-surgical methods like enzyme injections or steroid injections.
I use all these options in my patients depending on the severity of the disease. The pros and cons of each procedure are discussed with the patient so that he can make an informed decision before the procedure.