Dupuytren’s contracture, also known as Dupuytren’s disease or Vikings disease, is a condition that causes one or more fingers to pull inward toward the palm, making it difficult for them to be fully straightened. The disease is named after the French surgeon, Baron Guillaume Dupuytren, who first researched it in 1834. The disease usually occurs in men over 50 and in women over 60, although cases of the condition have also been reported in children.
Dupuytren’s contracture is caused by a thickening of the tissues under the skin of the palm which form nodules (small, hard lumps). The lumps can measure between 0.5 to one centimetre in diameter. The nodules are benign (non-cancerous) but can multiply and extend into ‘cords’, which will eventually pull down on the fingers. The condition may be mild and painless at first but can progressively worsen over time. While this condition may not be life-threatening, it can be a burden and—in some cases—fairly disabling.
Causes
It is unknown why this Dupuytren’s contracture develops in certain individuals, although there are some factors that make it more likely to appear. Genetics is one of the most outstanding factors—between four and seven out of every 10 people with the condition report a family history of it. Other possible causes can include diabetes, specific treatments for epilepsy, heavy drinking and smoking.
Treatment
In more severe cases of Dupuytren’s disease, your doctor may decide that surgery is necessary to repair the hand structure. The two main types of surgery for the condition are open fasciotomy and a fasciectomy. Corrective surgery can involve a number of risks and may not be suitable for frail patients. This type of procedure will therefore only be suggested if absolutely necessary.
The most common treatment for Dupuytren’s contracture is a surgical procedure called ‘limited fasciectomy’ in which the affected tissue (the cord causing the contracture) is removed usually under general anaesthetic. Mild-to-moderate cases of Dupuytren’s can be treated with less invasive kinds of surgery, or sometimes with no surgery at all. In the early stage of the disease (before the cord has started to contract) there has been some experimentation with radiotherapy. A surgical procedure called ‘needle fasciotomy’ can be used and consists in the surgeon using a blade or a hypodermic needle to cut through the cord without first opening the hand. In the last five years, a non-surgical enzyme treatment has been developed. The surgeon injects it into the cord where the enzyme dissolves the Dupuytren’s tissues. A few days later, the surgeon gently stretches the cord until it breaks.
For more information on all treatment options, visit thisisdupuytrens.com
