Dupuytren’s Contracture

Dupuytren’s contracture is a condition of the hand wherein a thickening and tightening of fibrous tissue (palmar fascia) under the skin begins to cause the fingers to curl and flex inward. Although generally painless, the result of the contraction can limit the use of the hand, thus affecting one’s abilities and lifestyle.

For some affected by Dupuytren’s, like Altamonte’s Randy Kline, a recent patient of Orlando Orthopedic Center’s Alan W. Christensen, M.D., treatment involves undergoing the minimally invasive needle fasciotomy procedure. Benefits associated with this procedure include an outpatient setting, local anesthesia and little to no recovery time.

“[Dupuytren’s effect] is gradual, but it eventually gets in the way of anything you want to do. I play guitar and piano and I remember sitting down to play one day and going, ‘Oh my gosh, I can’t play anymore,’” Kline says. “My hand just clunked against the keyboard and that’s when I decided to get it fixed.”

Causes and Symptoms of Dupuytren’s Contracture

Although the cause of Dupuytren’s contracture is unknown, several risk factors have been identified.

  • It is more common in men than women
  • It is most common in people of Northern European or Scandinavian ancestry
  • It increases in frequency with age
  • It often runs in families
  • It may be associated with certain medical conditions, such as diabetes or seizures

There is no conclusive evidence that hand trauma, overuse or specific occupational exposures lead to a higher risk in developing the disease.

Dupuytren’s may sometimes result in small, tender lumps (nodules) on the hand, but the most obvious symptom is curled fingers toward the palm. The ring and little fingers are most commonly affected.

Treating Dupuytren’s Contracture

Treatment options for Dupuytren’s vary depending on the stage of the disease. In the early stages, XIAFLEX injections and needle aponeurotomy are options; however more advanced cases are generally treated with hand surgery.

For Kline, his treatment path led him to receiving the minimally invasive needle fasciotomy from Dr. Christensen. This outpatient procedure is generally completed within an hour, often resulting in little to no down time and no physical therapy for patients.

“In this procedure the hardened cords in the hand are weakened through multiple insertions and manipulations of a small needle at various predetermined sections of the hand,” says Dr. Christensen. “Once the cord sections are weakened the cords can be snapped by pulling the finger straight. From there we dress the area and send the patient on their way.”

According to Dr. Christensen, patients are generally able to use their hand normally within one week following the procedure. Some swelling and soreness may occur, but the rate of complications for the procedure is very low.

“Needle fasciotomy is done with local anesthesia and allows patients a very rapid return to normal activities so generally patients are very satisfied with the results,” he says.  

Kline says he noticed the change immediately and he couldn’t be happier with the results.

“The procedure that Dr. Christensen used did produced results right away. In the surgery room I heard the pop noise, and just like that it was freed up,” he says. “There was no recovery time either. I went in and about an hour later I was walking out with no pain and a straight finger.”

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