The deformity of your finger(s) is caused by thickening of fibrous tissue beneath the skin forming nodules in the skin or a tight band from the palm to the finger. The band contracts bends the finger(s) down towards the palm. This commonly involves the little or ring fingers but can involve other digits. This worsens over time, but the rate varies between individuals.
Dupuytrens disease is usually painless but can cause some slight discomfort. The main problem is the inability to fully extend the finger making use of the hand difficult.
What treatment is available?
In less severe cases, no treatment is required. Physiotherapy and splint treatment are of no value. In severe cases when there is inability to lie the hand flat on a tabletop, treatment is possible. Collagenase injections can be used in some cases, but others may require surgery. Minor releases can be performed under local anaesthetic, but more extensive surgery requires a full or regional anaesthetic.
What does the treatment involve?
Collagenase injections dissolve part of the diseased tissue which can then be snapped by gentle manipulation to correct the deformity.
Fasciotomy is a minor release of the band in the palm under local anaesthetic. This is only suitable for some cases.
Fasciectomy is removal of the tight band of tissue from the palm up the finger. A zigzag incision up the finger(s), overlying the tight band is used. In very severe or recurrent cases a skin graft is used as there is loss of skin. The deformity can usually be improved by surgery. Full correction can be obtained in mild to moderate cases, but in severe cases residual deformity of the finger(s) can occur.
Are there any risks?
During the surgery, the nerve(s) to the finger may be damaged, although this is rarely permanent (1%). The wound takes 2-3 weeks to heal and full function can take 6-8 weeks. Infection can occur but is simple to treat with antibiotics. Stiffness and swelling can occur which can be severe in a small number of cases taking several months to resolve.
Does it come back?
Recurrence of the deformity is common but may takes several years or more.