QUESTION: A 65 year old woman is having trouble straightening her fingers and holding her hand flat. There is a thick cord-like structure in the middle of her palm making it awkward to out on gloves or shake hands. What is the issue?
What Is It?
Dupuytren’s contracture or “Vikings Disease” is a thickening and shortening of tissue in the palm (palmar fascia), resulting in clawed fingers as they are pulled towards the hand. The exact cause is unknown however, Scandinavian and Celtic (Viking) ancestry has been linked to it along with other risk factors including advancing age, epilepsy, alcoholism and diabetes.
Symptoms of Dupuytren’s Contracture
• A lump or nodule appears on the palm, usually close to the base of the ring or little finger.
• There is the appearance of a thickened cord running along the palm to the fingers.
• Over time, as the contracture develops, the fingers become clawed as they are pulled towards the palm.
Treatment for Dupuytren’s contracture varies between collagenase injections, needle release (fasciotomy) and surgery to remove the thickened fascia (fasciectomy). The treatment is determined by your hand surgeon on the severity of the contracture and potentially how many joints and fingers it is affecting.
When Is Hand Therapy Necessary?
Hand therapy is required post-surgery or injection to help maintain the gains made by the intervention chosen by the surgeon. This usually includes a custom made thermoplastic splint for night use to maintain the extension (straightening) of the fingers. Scar massage and exercises are also provided to increase the flexibility of the fingers and prevent further complications.
Here at Hand Therapy Group we work very closely with hand surgeons who regularly treat Dupuytren’s and can help find the best option to suit you. If you have any questions, please give us a call, we’d be glad to help!