This progressive condition results when fibrous tissue beneath the skin called the palmar fascia, becomes thickened. With time one or more fingers can become permanently bent towards the palm with this clawing. The ring and little fingers are predominantly affected but it can develop in any finger. Dupuytren’s contracture can create serious challenges in your ability to perform daily tasks.
Traditionally surgery has been the primary modality to treat this condition, with either a comprehensive excision of all the Dupuytren’s tissue (fasciectomy) or the less invasive needle fasciotomy.
Candidates for the Dupuytren’s surgery:
- People who have noticeable difficulty uncurling their fingers and palm.
- Those who can feel a rope like cord in the palm of their hand causing tightening of their fingers.
About Dupuytren’s fasciectomy surgery:
Generally performed under a general anaesthetic, the tight fascial bands are released and excised. The scar in the palm and fingers is altered to create a zig zag effect to minimise postoperative scar problems.
At the first dressing change a night splint is made which is worn for 4-6 weeks.
While surgery is very successful more recently a non-surgical option has become available utilising an injectable collagenase (Xiaflex). Dr Thomas has undertaken a specific training course and is certified to administer the collagenase enzyme Xiaflex.
Candidates for collagenase injection:
- People who have Dupuytren’s disease, especially in the palm.
- Patients wanting avoid an operation and have reduced downtime with a faster recovery.
About collagenase injection:
- A light dressing will be applied to the hand, a custom made splint will be fitted to be worn at night for 4 weeks.
- Dr Thomas will ask you to return in 30 days to check on the progress and recovery.