Dupuytren’s Disease And Hand Therapy

What Is Dupuytren’s Disease?

Dupuytren’s Disease is often a hereditary condition that can progress over many years, whereby the finger/s curl into a bent position and are unable to be straightened. Initially, the condition is characterised by firm lumps, nodules or cords within the palm of the hand that can worsen and progressively cause the affected finger/s to bend forwards towards the palm. These finger contractures cause significant functional limitations to the hand.  

How Is It Treated?

Surgical intervention is often recommended in patients with Dupuytren’s Disease when the major knuckle/s of a finger is bent at least at 30°. 

Surgical interventions include:

• Percutaneous Needle Aponeurotomy: a fine-tipped needle is injected through the skin at multiple locations to weaken and rupture the contracting cord.
• Fasciotomy: the bent finger is stretched after a longitudinal incision is made to divide the contracting cord. No tissue under the skin is removed.
• Fasciectomy: generous skin incisions are made for the careful removal of the affected underlying tissue. A skin graft may be used to cover the wound.
• Collagenase fasciotomy: An enzyme is injected to break down the collagen in the contracted cord. After 24 hours, the surgeon ruptures the contracted cord by manually extending the bent finger. 

Hand therapy after the above procedures is imperative to ensure the full use of the hand is regained. A hand therapist can help the patient achieve the best postoperative results and maintain the ‘straightness’ of the finger/s that was achieved from the surgery. 

Hand therapy may include:

• Wound Management: Working together with the therapist to help the hand stay clean and heal faster.
• Custom Splinting: a splint provides a gentle stretch to the parts of the hand that have become shortened and to resist the effects of the formation of the scar. 
• Exercises: it is important to begin moving the hand shortly after surgery. A therapist can guide the patient through a home exercise program to help reduce swelling and restore the function of the hand.
• Scar Management: this may include scar massage, use of silicone or tape, and exercises to promote healthy tissue healing and improve movement.

Summary

Dupuytren’s Disease starts with the presence of nodules or cords within the palm that can progressively contract the affected finger/s toward the palm. Our therapists at Melbourne Hand Therapy can help if you are experiencing any of these symptoms, or you are having surgery for Dupuytren’s contracture.

Please call us at Melbourne Hand Therapy today (03) 9899 8490 or leave an enquiry and we will get back to you as soon as possible.