Dupuytren’s contracture affects the hands and fingers. It causes one or more fingers to bend into the palm of the hand and it can affect one or both hands, and sometimes affect the thumb. Dupuytren’s contracture occurs when the connective tissue in the palm thickens. Often the tissue thickens in one small area first and a “nodule” forms (a small, hard lump about 0.5-1cm) under the skin of the palm. The nodule sometimes feels tender to begin with, but this usually passes. More nodules may then develop.
The nodules are non-cancerous (benign) and the condition isn’t life-threatening for those who develop it, although it can be a nuisance to live with. Over time, the nodules can extend and form cords of tissue. These cords can shorten (contract) and, if the cords run along a finger or thumb, they can pull it, so it becomes bent towards the palm. These contractures are often mild and painless, but they can get steadily worse over time.
Many cases of Dupuytren’s contracture are mild and don’t need treatment.
Treatment may be helpful if the condition is interfering with the normal function of the hand. Non-surgical treatments include radiation therapy and injections with a medication called collagenase.
Alternatively, a minor procedure that involves using a needle to cut the contracted cord of tissue (needle fasciotomy) may be recommended. A needle fasciotomy is also known as a needle aponeurotomy or a percutaneous needle fasciotomy (percutaneous means “performed through the skin”).
You will be given a local anaesthetic that will numb your hand without making you lose consciousness. During the procedure, a sharp blade or a very fine needle will be inserted into the fibrous bands in the palm of your hand or your fingers. The blade or needle will be used to divide the cord under your skin. By dividing the thickened tissue, your surgeon will release the tightness in your hand that is forcing your finger to bend. The benefits of needle fasciotomy include: your fingers are less deformed, you recover more quickly compared to more extensive surgery, it is suitable for people who are unable to have more extensive surgery, such as the very frail or elderly.
This surgery can be done under local anaesthetic without a tourniquet which means you will not have to stay in hospital overnight and can have this operation even if you are medically not fit enough for a general anaesthetic.