Putting a Finger on Dupuytren’s Contracture
Dr. Paul Fragner, Hand Surgeon
November 12, 2019
A simple new treatment for a common hand condition helps people regain full mobility quickly and without surgery.
Throughout history, it’s been called the “Viking Disease” for its prevalence in Nordic countries and “Curse of the McCrimmons,” referring to a Scottish clan whose bagpipers could no longer play their instruments because of deformed hands.
Today, we know it as Dupuytren’s contracture – a slowly crippling hand condition that affects an estimated 16 million Americans. As it often shows up in middle age, many people mistake the telltale knots under the skin of the palm as an injury or arthritis as it affects their ability to perform everyday activities or do hobbies they once enjoyed.
You may have even recently seen former NFL star John Elway in the news to raise awareness of Dupuytren’s. He’d been suffering from the condition for years, to the point that he could no longer throw a football. President Ronald Reagan suffered from it as well as pianist Misha Dichter.
Dupuytren’s is named for the French surgeon who first operated on people suffering from the condition in 1831. We still don’t know what causes the connective tissue in the palm to progressively thicken over time, forming guitar string-like cords across the palm and over the knuckles, preventing the fingers from being straightened. The condition seems to run in families and affects a disproportionately large amount of people of Scandinavian, Celtic or Northern European descent.
Until recently, the only treatment for Dupuytren’s was surgery under general anesthesia to remove the tissue and free the fingers. But fortunately, there is now an FDA-approved non-surgical therapy that has revolutionized the treatment of Dupuytren’s contractures.
The injectable therapy is called collagenase clostridium histolyticum. While the injection doesn’t remove the knots under the skin, it has proven extremely effective at restoring flexibility to the finger joints in as little as a day after the quick, in-office procedure. Patients who have had the injections in my office are usually back to full activity in about a week.
According to the American Society of Surgery of the Hand, symptoms of Dupytren’s include:
- Difficulty placing the hand on a flat surface;
- Difficulty washing hands, wearing gloves, shaking hands and putting hands in pockets;
- Uncomfortable lumps and pits within the palm;
- Cords from the palm into one or more fingers;
- Bending of fingers toward the palm, most commonly the ring and pinkie fingers.
Timing is everything with the treatment of Dupytren’s as not all knots require treatment or will necessarily progress. It’s important to be alert to these symptoms and alert your doctor as early as possible so they can observe the condition’s progression and decide whether treatment is necessary.
Dr. Paul Fragner is an orthopedic surgeon with expertise in hand, wrist and elbow surgery, treating patients in our West Harrison and Armonk locations. To schedule an appointment for either location call (914) 946-1010.
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