Author Topic: Dupuytren's contracture  (Read 4658 times)

Carebear

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Dupuytren's contracture
« on: October 20, 2014, 03:37:04 PM »
Dear Friends of Sjogren's,

I would like to hear from anyone who has Dupuytren's contracture or is familiar with the condition.  I am especially interested to learn exactly WHO can treat this.

I am highly suspicious of a hard, narrow lump on my palm.  It is below the ring finger, running away the ligament for about an inch.  The associated finger is often swollen as well.  I noticed it about two months ago.  It can hurt when I grip the steering wheel, wear snug gloves or use a screw driver, so I know that it is time to seek medical advice.  But remember, my doctors are the ones who give the blank stare or shrug when I show up with something new.

Reading about it looks like there is little to do to improve it, save surgery.  And it may be an autoimmune disease. Thankfully not life threatening but one more thing to add to my list I suppose.

Thanks all!

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Jasper

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Re: Dupuytren's contracture
« Reply #1 on: October 20, 2014, 04:21:28 PM »
I have Dupuytren's contracture in my left palm,  a little below my left ring finger. I first noticed it last spring, maybe about May.

It does hurt a little if I stretch it or put pressure on it, but normally it does not bother me. So far my fingers are in alignment and they are not contracted. I don't have any of the risk factors that are normally listed in the older articles, but I see that the newer articles are listing Autoimmune issues as a cause and I obviously have Autoimmune issues. And this makes a lot of sense since many Autoimmune Diseases affect the connective tissue.

I have not sought any treatment yet but am contemplating seeing an orthopedic surgeon who specializes in hands. I'm not sure they will do anything about it unless it is gets worse and starts to compromise movement and activity. But, I could be wrong about that. Anyway, I will see an orthopedic surgeon who specializes in hands.

As far as treatments are concerned, they can do needling (to break the cord), enzyme injections (to weaken the cord), or surgery. The contracture can come back after the procedure.

http://www.mayoclinic.org/diseases-conditions/dupuytrens-contracture/basics/definition/con-20024378
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Sooki

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Re: Dupuytren's contracture
« Reply #2 on: October 20, 2014, 05:54:55 PM »
Yes, I had a Dupuytren's contracture on my little finger.  The tendon grew scar tissue all along it and bent my finger down.  It was at about 60 degrees within the year. 

A hand surgeon is the person to speak with.  I found one who did an excellent surgical job, especially since the tendon in the little finger has a nerve wrapped around it.  It took physical therapy afterwards to be able to straighten, and then to bend, the joint again.  Be sure to find a good PT who specializes in hands.

Every doctor I've spoken with has said it's not autoimmune, but genetic.  But I'm not convinced. 

The doctor told me that the injections are actually a toxin, related to botulinum toxin.  I wasn't sure how my immune system would react to that.  In addition, the doc said that the results are unpredictable - too much and you can harm healthy surrounding tissue, possibly even harming finger function.  He said surgery was a much better option.

The bad news in any case, is that the contracture can come back.  Sometimes it's 10-20 years.  Sometimes 5.  I asked him about the minimum - occasionally it's as often as 2 years or less.  I'm guessing mine will reoccur before too long.

My finger joint was so swollen before the surgery that it's been hard to get it to straighten and keep straight without wearing an oval finger splint for some part of each day (It's been a year). A friend without inflammatory arthritis but with the same condition, same surgeon, healed quickly and totally. That said, it was a successful surgery.  There was pretty much no surgical pain afterwards.  The healing was fast.  And I could use my finger (although not be very dexterous) as soon as the cast was off (2 weeks).

I'm also growing a hard lump on the palm below the ring finger of the same hand.  There isn't any contracture yet.  But that finger also has trigger behavior.  Trigger fingers are an easy once-in-a-lifetime (they say) little surgery.  I'm hoping the lump doesn't become a contracture.  I don't know of any preemptive practices or treatments.

A good hand surgeon will be able to tell you lots about your situation and your best treatment options. 
 
 
« Last Edit: October 20, 2014, 05:57:52 PM by Sooki »
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A66eyroad

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Re: Dupuytren's contracture
« Reply #3 on: October 21, 2014, 05:40:49 AM »
My sister has this, in both hands and both feet. It causes the fingers and toes to draw up into a ball. She has told me that, when you see a "wicked witch" with her hands balled up into claws, it's because of Dupuytren's.

Here's a link to a great website set up by the Dupuytren Foundation:  http://dupuytrens.org/
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Scottietottie

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Re: Dupuytren's contracture
« Reply #4 on: October 21, 2014, 08:43:21 AM »
Hi  :)

I also have a dx of Dupuytrens after developing a small lump on the palm of one hand. So far it hasn't caused any contraction so its a case of "wait and see what happens".

I have read that surgery is usually pretty successful when it gets to the stage that surgery is a good idea.

Take care - Scottie  :)
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long time dry

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Re: Dupuytren's contracture
« Reply #5 on: October 21, 2014, 11:26:46 AM »
I've had this for several years and it has changed very little.  When I last saw the hand surgeon, she told me to wait until there was significant contracture before seeking surgery.  That made sense to me.  Everything I've read has stated that it is not autoimmune related but is inherited.  Since I have family members with both conditions, although not together, I have wondered.

Although I have yet to need to do something about the Dupuytren's, I have had surgery on both hands for tendon issues.  One was for trigger finger and the other for DeQuervain's.  They were easy surgeries and the recovery time was very fast for both.  I've urged friends who need the surgery not to be afraid because the success rate is very high and the pain is usually minimal.

It is definitely important to see a hand surgeon and after surgery to go to a hand therapist.  They are the appropriate specialists.  Mine have both been excellent and I'm sure there must be many others who are as well.

Carebear

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Re: Dupuytren's contracture
« Reply #6 on: November 03, 2014, 01:19:32 PM »
Thank you everyone for your supportive replies.  You are always so informative.

I have been referred to a hand surgeon, so I feel relieved that what ever this is on my palm is being addressed.  Unfortunately it looks like it's getting larger, and my hand is getting weaker and more painful as a result.

So now I just wait.  And relax.   ;)
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Carebear

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Re: Dupuytren's contracture
« Reply #7 on: November 25, 2014, 06:49:38 PM »
I saw the surgeon this week, and he agreed that I do have Dupuytren's contracture in my right hand.  And it is just beginning in my right foot and left hand as well.

The pain has been significant this last couple of months so he gave me a cortisone injection to bring down the inflammation.  That hurt like a son of a gun but two days later it is feeling much better than it has in a long time.

Once the finger curls up enough he will inject the hand with an enzyme which he says "does a fantastic job".  When my foot gets bad he will prescribe orthodics.  All in all, I felt well cared for by a very experienced man.  I wish more were like him.

The surgeon links this to my rheumotoid arthritis because it can be caused by a leaking of synovial fluid in the ligaments.  Sounds reasonable. 
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Carolina

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Re: Dupuytren's contracture
« Reply #8 on: November 25, 2014, 07:06:45 PM »
And, as a general rule, those of us with Immune Mediated conditions are prone to tendon problems, like Carpal Tunnel Syndrome and Plantar's Fascitis and Trigger Finger (my trio so far).

It's always somethings....and then, by golly, it's something else!

Hugs,,  Elaine
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Carebear

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Re: Dupuytren's contracture
« Reply #9 on: November 25, 2014, 07:45:32 PM »
Oh, Elaine.  Ain't that the truth!
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Sooki

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Re: Dupuytren's contracture
« Reply #10 on: November 26, 2014, 08:42:37 AM »
Carebear - please keep us posted on how your treatment goes.  I had the surgery, but haven't heard from anyone who has used the enzyme treatment. I (and others) will surely need additional treatment in the future.  I hope it does its work and your contracture is vastly improved soon!  Sooki
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Carebear

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Re: Dupuytren's contracture
« Reply #11 on: November 26, 2014, 08:10:22 PM »
Sooki,

I will definitely let you know how this goes when I get to that stage.  Let's hope it's later rather than sooner!

As an aside, my hand is almost pain free now.  Darn.  One less excuse not to shovel snow.  :)
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kikil

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Re: Dupuytren's contracture
« Reply #12 on: November 26, 2014, 08:36:43 PM »
I have Dupuytren's contracture on my left hand. It first became evident after my pinky was crushed (slammed in the door). The finger was operated on twice.

The doctor said it was an inherited condition, and that it did not need to be corrected surgically since the hand is still flexible.

An interesting topic!