Dupuytren’s Contracture- More than just a crooked finger
December 23, 2015
You may have seen someone with a “crooked finger” or may have one yourself. There was no injury to cause the problem. It just seemed to gradually get more pronounced. Usually, the ring or small finger is the one affected. Most people do not consult with their doctor until it begins interfering with function-- when you reach in your pocket, you can’t get the finger in easily or you pull out objects you didn’t mean to pull out.
Your doctor will examine your hand and take a careful history. Eliminating the possibility of an injury to the digit, the doctor may diagnose you as having Dupuytren’s disease. This is a thickening of the dense tissue in the palm that is called fascia. It usually begins as a sore knot in the palm. As it progresses, a distinctive cord can develop that actually begins to bend the finger into the palm, making it difficult or even painful to straighten out the finger. Left untreated, the finger will continue to bend and be a nuisance. In some cases, it can flex so much that it can become a hygiene problem.
Your next step is to consult with a hand surgeon to review your options. The most common approach is to have surgery to remove the diseased palmar fascia. Following the surgery, you are placed in a splint for night time to keep the finger straight. Sutures come out at 2weeks post op and you are allowed to gradually return to using the hand with daily activities. On occasion it is necessary to havetherapy to help you get your fingers moving well. Therapy will involve active exercise, modalities to soften the tissues in the palm, and gradual strengthening to help you return to your daily activities.