The power of our hands - Dupuytren’s Contracture
By Laura L Tharp, M.D.
It was said by Ralph Waldo Emerson that, “Power and speed be hands and feet.” And, well, we have to agree. Our hands are powerful tools indeed. From lifting, to grabbing, to writing, to creating, our hands are the ultimate power tools.
Have you ever stopped to think how the loss of movement and mobility in your hands will affect your everyday power? For most of us, we don’t have to think about it, but for those with Dupuytren’s Contracture it’s a very real struggle. Dupuytren’s Contracture may be something you’ve never heard of (and difficult to pronounce) however we expect by the end of this article, you’ll understand a little more and may even know someone suffering from this condition.
First of all, let’s clarify the pronunciation. According to Merriam-Webster.com, the word dupuytren is pronounced both “du-pwe-tranz” and “du-pwe-trenz” so kind of like that “to-may-toe” and “to-ma-toe” thing….choose the one you prefer and roll with it. A rhyming word to compare it to would help, however one doesn’t seem to come to mind, so we will carry on.
Now that we all have an idea how to pronounce the word, let’s get a little more serious and learn more about this condition. In short, Dupuytren’s Contracture is a condition in which one or more fingers become permanently bent inwards towards the palm of the hand. This typically happens over a period of several years and most commonly affects the index and pinky fingers. The condition usually begins as small lumps or nodules in the palm of the hand and these lumps often progress, affecting a layer of the fibrous, connective tissue directly under the skin. This fibrous tissue thickens and tightens, causing the affected fingers to progressively stiffen and lose their flexibility, curling towards the palm. The severity of the condition will vary person to person and oftentimes is more severe in one hand.
The initial lumps can be uncomfortable and perhaps tender to the touch, however the condition typically does not involve major pain. Therefore, if pain is involved it could be another condition of the hand such as tendonitis so this is why it’s important to let a physician evaluate and diagnose.
There are various treatments for Dupuytren’s Contracture. Surgery is not always necessary, but it often becomes the preferred choice of many sufferers. It is only necessary to surgically treat this condition when it begins to affect your daily life. Many of those who suffer from Dupuytren’s complain of losing their grip and range of motion, which can become troublesome when doing some of the simplest daily tasks such as brushing your hair or putting your hands in your pockets. Each patient should be assessed individually to determine the stage and pattern of the disease. Once assessed, all treatment options can be explored, including non-surgical interventions such as stretches, injections, and other therapies that may slow the progression and even improve flexibility. Surgical procedures have proven to return flexibility and range of motion however; this does involve recovery time as well as physical therapy to maximize that flexibility and range of motion post-surgery.
Although it can affect women, Dupuytren’s Contracture has proven more common in men over the age of 40 with northern European decent. Alcohol and tobacco use, diabetes, and epilepsy appear to result in an increased risk for this disease, although not enough studies have been completed to pinpoint exact causes of this condition.
About the author: Dr. Laura Tharp, a native of Fitzgerald, Georgia is an orthopedic surgeon with Orthopedic Surgeons of Georgia. Dr. Tharp is Fellowship Trained from the University of Miami in disorders of the upper extremity, with many years’ experience in issues of the hand, wrist, and elbow including Dupuytren’s Contracture.
For more information about Dr. Laura Tharp and the orthopedic team at Orthopedic Surgeons of Georgia visit their website online at www.Orthopedic SurgeonsofGa.com or, to make an appointment with Dr. Laura Tharp, call (912) 383-6575. Her office is located in Douglas, Ga next to Coffee Regional Medical Center.