Dupuytren’s Contracture

Dupuytren’s ContractureBack in 2003, I went to an orthopaedic surgeon that specialized in hands because I had trigger finger.  When he looked at my hands, he told me that I had Dupuytren’s Contracture because I had a tiny little dimple in the palm of my hand.  At the time, I thought he was nuts but it turns out, he was right.  I should add that this was the same surgeon that also wanted to operate on both hands at the same time and told me it was OK to drive myself home after surgery.

Dupuytren’s Contracture is something that diabetics have a greater risk for of getting than other groups of people.  People with ancestry from Northern Europe, especially those from Viking descent, are also at a greater risk – my ancestors came from Ireland.

I don’t know if it is common to start out with the dimple like I had or not – that is how mine started but if you read about Dupuytren’s Contracture, it doesn’t always mention the dimple.  Those dimples eventually turned into lumps.  I just kind of take it for granted that they are there but last summer when I had a heart catheterization, the nurse that put my IV in kind of freaked when she felt the lump in my hand.  I can never remember the proper name and when talking to someone about it, I always just say that weird disease that starts with a D.  She couldn’t remember the name either but knew what I was talking about.

Besides the lumps in the palm of your hand, your fingers can also curl.  The ring finger can be one of the most affected fingers – my ring finger is my worse finger and it is not that curved.  My little finger on that same hand is also curved some.  If you look at the picture of my hand, my lumps are below the ring finger.

 Dupuytren’s Contracture

Treatment for Dupuytren’s Contracture is hard to come by.  One option is needle aponeurotomy.  A needle is used to puncture the Dupuytren’s cord to weaken it and then break it.  Once the Dupuytren’s cord is broken, then the fingers can be straightened.  It is less invasive than surgery and can be repeated as needed.  The downside is that there are not that many doctors in the US trained in the procedure.

Another option is surgery.  Surgery is not done until later stages of the disease.  As with any surgery, there is a chance of infection and there is also a chance of nerve damage.

A third option is radiation therapy.  This treatment is best in the initial stages of Dupuytren’s Contracture.  You have to go for 5 days straight.   The radiation will slow down the progress of the disease.  This is also a hard treatment to obtain in the US.

The newest treatment for Dupuytren’s Contracture is a drug called Xiaflex.  As with many new drugs, it is expensive – I read that it is about $3k a shot and you may need several.  Xiaflex was approved for use in the US by the FDA in February, 2010.  The Xiaflex is injected into the Dupuytren’s cord to weaken it and allow it to be mechanically broken, allowing the fingers to return to normal.

One interesting thing that I read is that taking Glucosamine Chondroitin can actually cause the nodules to grow faster.  So if you already have Dupuytren’s Contracture, be very careful taking Glucosamine Chondroitin!

Here are two useful links for more information on Dupuytren’s Contracture:

http://www.dupuytrenfoundation.org/

http://www.dupuytren-online.info/index.html
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9 thoughts on “Dupuytren’s Contracture

  1. I have had the nodules and some tightening of tendons in the hand….took glucosamine/ chondroitin for some time and no change..( did not get worse)….about 2 months a ago I stopped it..and suddenly today my tendons are worse…that research that said G/Ch makes it worse is very old research..I do not believe it…I thnk it helped..I am going back on it today…Ed

  2. Very interesting. The only thing I was told that if it got bad they would do surgery to “release” the tendons . The other day at my clinic they were giving free hand masssges. The lady did freak a little when she went over the bumps I have one in each hand.

  3. Kelly,

    Thank you so much for your post. Because of it I now know what is going on with my hand. I have already gone to the xiaflex site as a result of the post as well. Mine started with a dimple. Also, I had a grandfather straight off of the boat via Ireland. As an aside, not that I have Diabetes, but there is a new site that I came across that offers price comaprison shopping related to diabetic testing supplies- DiabetesPharmacy.com. Thanks once again. I am sure that others have been enlightened by your post as well…

    • Minnesota Nice, when I saw you mentioned the lumps, I had a feeling you had the same thing. I think some of the doctors don’t necessarily keep up with the latest treatments. I was also told that they would do surgery when they got bad. When I started looking into it, I discovered there were other treatments available. Mine really have not progressed that far so hopefully, yours won’t either!

  4. KellY:

    You have a great web site. thank you for sharing your story. I am so sorry to hear of your plight. as regional director for auxilium, the company with xiaflex, i encourage your spend some time on our website. a few important things to note, are that many hand surgeons are having very good success with thier xiaflex injections at reducing contracture and two, most insurance companies are covering the xiaflex. we have extensive resources available to assist people with dupuytren and thier health care providers as they navigate the health care insurance junlge.

    • Thanks Mike! I did look at the Xiaflex site. I used the physician finder and saw there are a bunch of doctors in Pittsburgh using it. I live a couple hours from Pittsburgh but go there when I want a good doctor! I am going to print out the list and send it to one of the other doctors I see there to see if he knows anyone on that list. I first heard about Xiaflex back in July when a friend told me she read about it in Arthritis Today. I am definitely interested. I was worried with it being so new, it would be hard to get insurance to pay for it but I will check with my insurance.

  5. Hi,
    I, too have Dupuytren’s Contracture. I spoke with my hand surgeon and she told me of all the cuts on the hand they would have to make to remove the lumps and release the tendons. She told me to wait quite a while until my hands were more or less incable.
    Friends have looked at my hands and touched my palms. They “grossed out”! It does not hurt, thank God. Trigger fingers are much worse as far as pain goes. We have a lot in common!

    • Hi Gail,

      There are other options besides the surgery and you won’t have to wait until your hands are totally messed up. The problem is finding a good doctor! I looked on the Xiaflex site and they do have a doctor finder feature. You might want to see if someone in your area is using that. I am going to check it out. I don’t want to wait until my hands are useless before trying to get them fixed!

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