Dupuytrens cannot be cured. The goals of the treatment are to slow the progression of the disease or to improve hand function. As long as the condition doesn’t cause pain and the affected person can use the hands for everyday tasks, he/she might not need treatment. Instead, the patient can wait and check with the doctor if Dupuytrens develops over time.
Self help
Patients with mild symptoms may improve the condition by:
- Warming fingers up, e.g. with a heat pack
- Massaging the fingers with lanolin cream
- Stretching the fingers (e.g. bending them backward from the palm)
- Protecting the fingers (e.g. gloves with padding in order to grasp heavy objects)
Nonsurgical treatment
If the condition is more severe, treatment involves removing or breaking apart the cords that are pulling the fingers toward the palm. Treatment options depend on the severity of the disease and other health problems of the patients.
Needling
A needle is inserted through the skin in order to puncture and break the cord of tissue that's contracting a finger. If the contractures recur, needling can be repeated. Advantage of the procedure: There is no incision, and it can be done on several fingers at the same time. Afterwards, only little physical therapy is usually needed. Disadvantage: The physician cannot puncture in all locations in the finger, because in some places, he could damage a nerve or tendon.
Enzyme injections
Compared to needling, enzyme injections might be more painful in the beginning. Apart from that, the advantages and disadvantages are similar. The goal of an enzyme injection is to soften and weaken the taut cord in the palm. That allows the doctor to manipulate the hand and to break the cord and straighten the fingers, if possible.
Surgery
Another option is operation: The surgeon removes the affected tissue in the palm. Sometimes it’s difficult to identify tissue in very early stages of Dupuytrens. If the affected tissue is attached to the skin, it might not be easy to remove. Advantage of surgery: The joint release is more complete in comparison with needling and enzyme injections. Disadvantages: Physical therapy is normally required after surgery, and the recovery time may be longer.
If the patient suffers from severe Dupuytren's contracture, the surgeon may perform a very invasive operation by removing all the tissue likely to be affected by the disease, including the attached skin. Afterwards, a skin graft is required to cover the open wound. In general, the patients need months of intensive physical therapy after the procedure.
Preventive measures
The disease cannot be prevented. If symptoms occur, a doctor’s visit is needed.
