Back 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.
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: