Dupuytren’s disease is a connective tissue disease the affects one or both of the hands. The disease causes raised nodules and dimples in the skin of the palm which progress to eventually tightening the skin and pulling the fingers into a bent position. The fingers most often affected are the thumb, ring and/or small fingers.
This condition usually takes many years to develop and is more common in men than women. Most often a person will first notice a painless cord or nodule in the palm. As the disease progresses, pitting of the skin and tightening of the cords causing difficulty straightening the fingers. It may be difficult to lay the hand flat on a table, put on gloves, shaking hands, or retrieve coins from a pocket.
Most often bending the fingers remains functional; however, activities involving opening the hand are problematic such as grasp and release of large objects. Function will continue to become more limited as the fingers curl and cannot be opened or spread apart.
Fingers that stay in a bent position over a long period of time can be very difficult to straighten again even with a surgical procedure. If the disease progresses beyond a severe stage, the circulation and nerve function of the fingers could be compromised.
What to expect from therapy
The most successful means of correcting Dupuytren’s Disease is through surgical removal of the diseased tissue from the palm and the fingers. Nonoperative treatment, including splinting, stretching, and exercises has not been effective.
A therapist may be helpful in providing education regarding the disease process and possible complications if intervention is not sought when normal hand function is compromised. Surgery will be performed when the disease has progressed to a stage where function has become limited and/or difficult.
Following surgery you will be referred to a therapist to assist you in the healing process. Treatment will include wound care, reducing the swelling, providing you with custom splinting to maintain straight fingers, and movement exercises.
As healing progresses, your therapist will instruct you in scar management, massage and strengthening. Treatment may also include various modalities like heat, ice, or ultrasound. Your therapist will provide education and training to allow you to return to normal home, work and leisure activities as quickly as possible.