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Tag: Dupuytren’s Contracture

Fingers Hands

Is My Finger Permanently Bent? | Dupuytren’s Contracture: What You Should Know

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If you have fingers that look as if they bend permanently toward your palm, there’s a strong chance you have Dupuytren’s Contracture, a rare type of hand disorder that tends to take a number of years to develop. Many individuals mistake this condition for trigger finger, but the main difference is that Dupuytren’s Contracture affects the tissue while trigger finger involves the tendons. If you’re wondering “Is my finger permanently bent?” then continue reading to learn more about this condition.

Dupuytren’s Contracture has many names, some of which are:

  • Vikings disease
  • Contraction of palmar fascia
  • Dupuytren disease
  • Dupuytren’s contracture
  • Familial palmar fibromatosis
  • Palmar fascial fibromatosis
  • Palmar fibromas

This condition causes the layers of tissues that lay beneath the skin on the palm of the hand to begin to form knots. These knots thicken and can cause one or more of the fingers to bend, creating difficulty to perform normal, day-to-day tasks such as putting on gloves or grasping larger objects.

Dupuytren’s Contracture

In most cases, only the ring finger and the pinky are affected. In very rare cases, though, the condition can also affect the thumb and the index finger. An interesting fact is Dupuytren’s Contracture tends to affect older men who have a Northern European heritage.


What Is the Cause of Dupuytren’s Contracture?

Currently, the cause of Dupuytren’s Contracture is unknown. Researchers have not been able to find any evidence that it is related to hand injuries or any occupations that have repetitive stress issues from vibration. However, they have found a number of factors that can increase the risk of developing the condition.

  • Men, as mentioned before, are the most likely to develop the contracture, and it typically affects those who are 50 and over.
  • The condition also tends to run in families, indicating it could be genetic.
  • Those who have diabetes are also at an elevated risk.
  • Smoking can increase the risk of developing Dupuytren’s Contracture, as can alcohol.


Is My Finger Permanently Bent?

Once your fingers are bent from Dupuytren’s Contracture, it will no longer be possible to straighten them back to how they were before. Here at Arora Hand Surgery, we understand that this fact may be hurtful and jarring to hear.

However, we want to assure you that there are ways to reduce the effects of this condition through Dupuytren’s Contracture hand therapy, collagenase injection (a special enzyme that can soften and weaken larger lumps), needle injections that break up the hard tissue, or even Dupuytren’s Contracture hand surgery.

Speaking with a doctor is the first step in understanding how to proceed so that the condition can be reduced or even eliminated for several years.


Talking with a doctor.

You will want to speak with a hand specialist about this condition, so refer to your primary care physician who will then refer you to a local specialist. A hand specialist such as Dr. Avery Arora will want to know more about your medical history and how you have been dealing with the condition. Some questions Dr. Arora would ask would be:

  • Is a history of Dupuytren’s Contracture in your family?
  • Have you tried any Dupuyren’s Contracture treatments?
  • What medications are you taking?
  • When did the symptoms first start?
  • Are you experiencing pain?
  • Has the condition been getting gradually worse?
  • How does it affect your lifestyle?

Here at Arora Hand Surgery, we care about your health. If you are feeling finger, hand, wrist, or elbow pain, visit Dr. Avery Arora, Michigan’s top hand surgeon, at one of his southeast Michigan offices located in West Bloomfield, Warren, Macomb Township, or Howell.




Fingers General

Dupuytren’s Contracture vs. Trigger Finger: What is the Difference?

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When it comes to Dupuytren’s contracture vs. trigger finger, the differences are not always clear. On the surface, they have similar effects on the fingers. When you look deeper, however, you will see that the reason why the fingers are functioning the way they do is different.

Facts about Dupuytren’s Contracture vs. Trigger Finger

It’s easy to see why people may confuse the two conditions. They are similar in some ways. First of all, both conditions can affect any finger. Another similarity is the appearance. The affected fingers are typically curved inward toward the palm, although in some cases they can be bent to the left or right.

Otherwise, they are very different conditions. Following is a breakdown of the differences in Dupuytren’s contracture vs. trigger finger.

What is Trigger Finger?

The technical name for trigger finger is stenosing tenosynovitis. Trigger finger is caused when an injury causes a finger to get stuck in a bent position. This occurs when inflammation narrows the sheath around the tendons, leading to the formation of a nodule. When you flex this finger, the nodule must slide through the narrow sheath, causing a snapping sensation.

Treatment for trigger finger may include:

  • The use of medications to relieve pain
  • Therapy that includes rest, stretching exercises, and the use of a splint
  • Steroid injections
  • A percutaneous release procedure, where the hand surgeon uses a needle to break apart the constriction that is blocking proper movement
  • Surgery to loosen the constricted area
Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.
Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.

What is Dupuytren’s Contracture?

Dupuytren’s contracture develops over time. It begins when tissue forms knots under the skin of the palm. As these knots form, they create a cord that pulls the fingers into a bent position. Everyday activities like gripping silverware can become difficult with this condition.

Similar to one of the trigger finger treatment options, Dupuytren’s contracture can be treated with the needling procedure to break the cord of tissue that is causing a finger to contract. Other treatment options include self-care, Xiaflex enzyme injections, and surgery.

Surgery for Dupuytren’s contracture entails removing all the tissue that is affected, including the skin. A skin graft may be required to repair the wound. Because this is a serious procedure with a lengthy recovery time, it is ideal only for those who have a diminished quality of life due to the condition.

Dupuytren’s contracture develops over time and stems from the tissue in the palm.
Dupuytren’s contracture develops over time and stems from the tissue in the palm.

Differences Between the Two Hand Conditions

Following are some of the primary differences in Dupuytren’s contracture vs. trigger finger.

  1. Trigger finger starts with the fingers while Dupuytren’s contracture stems from the palm.
  2. Dupuytren’s contracture involves the tissue, but trigger finger involves the tendons.
  3. Trigger finger is most common in the thumb, index finger, and middle finger. Dupuytren’s contracture is most likely to occur in the fourth finger and the pinky.
  4. Someone who has trigger finger can straighten the finger if they tried, but someone with Dupuytren’s contracture cannot.
  5. Whereas trigger finger is usually the result of an injury, the causes of Dupuytren’s contracture are not clear.

If you have experienced a recent injury that led to trigger finger or have been seeing the effects of Dupuytren’s contracture progress over a number of years, see our hand specialist in Macomb, Warren, West Bloomfield, or Howell for treatment. Make an appointment by calling our office or sending our hand surgery team a message online.


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Conditions Fingers General Hands

What are the Causes of Dupuytren’s Contracture?

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Do you think you’re one of the approximately seven percent of Americans dealing with Dupuytren’s contracture? Do you even know what this surprisingly common condition is?

Read on to learn more about what Dupuytren’s contracture is and for some useful information on how to treat it and improve your quality of life.

What is Dupuytren’s Contracture?

Let’s start by clearing up what Dupuytren’s contracture actually is.

Dupuytren’s contracture, which is also known as Dupuytren’s disease, is a condition that involves the tightening and thickening of the fascia (connective tissue) of the fingers and palm of the hand.

Normally, fascia is very elastic. But, for people suffering from this condition, the fascia is tight, to the point where it can cause the fingers to curl inward. It can even cause severe deformities that limit overall hand function.

Common Causes

Dupuytren’s disease doesn’t have a single known cause. But researchers have found that it often runs in families, and people of certain heritages are more likely to develop it.

Those who are more susceptible to the condition include people of Northern European or Scandinavian descent.

Certain illnesses and lifestyle factors can influence a person’s likelihood of Dupuytren’s contracture, too. Common ones include:

  • Excessive alcohol consumption
  • Diabetes
  • Epilepsy and seizure disorders
  • Smoking

Men who are in their 40s or older are also more likely to develop Dupuytren’s disease than women. For both genders, the chances of being diagnosed increase with age.


How do you know if you have Dupuytren’s contracture?

Most people start by noticing small lumps, or nodules, under the skin on the palm of their hand. The nodules will usually be sore and tender at first, but the discomfort will subside with time.

After they first develop, these nodules will cause tough bands of connective tissue to appear under the skin. These bands will cause the fingers to curl inward and will hinder one’s ability to straighten their fingers.

The ring and pinkie fingers often are affected first.

Dupuytren’s contracture usually affects both hands, but one hand may present more serious symptoms than the other.

As the condition progresses, it can become difficult to perform everyday tasks like placing your hands in your pockets or picking up large objects. Even actions like shaking hands, wearing gloves, or placing your hand flat on a surface become challenging.

When Should You See a Hand Doctor?

The sooner you speak to a doctor about your condition, the sooner you can start treatment and avoid the debilitating symptoms that occur as the disease progresses.

If you notice lumps on your palm — even if they’re not painful — you should make an appointment with the doctor.

If you’re already experiencing more advanced symptoms, like difficulty straightening the fingers or grasping objects, it’s even more important for you to make an appointment.


When you visit the doctor, he will examine your wrists, hands, and fingers. He will pay special attention to the palms to check for nodules and count how many are currently present.

The doctor will also most likely have you perform a series of tasks to see how far the disease has progressed. Common tests include:

  • Placing your hand flat on a table
  • Grasping and pinching items with the hands and fingers
  • Checking the amount of feeling you have in the fingers and thumbs
  • Measuring range of motion

The doctor will repeat these tests and exams regularly to see if your condition is improving or getting worse.

Nonsurgical Treatment Options

Dupuytren’s contracture doesn’t have a cure. However, there are also a number of nonsurgical treatment options that the doctor will suggest first to help you manage your condition and improve your quality of life.

Some common nonsurgical treatments that the doctor will likely start with include:


When Dupuytren’s disease is in its earliest stages, many doctors start by recommending regular stretching exercises to improve range of motion and slow the disease’s progression.

Common exercises include flexion exercise, grip strengthening exercises, and isolation exercises.

Steroid Injections

An injection of corticosteroids, a type of anti-inflammatory medication, can help reduce the size of nodules when the disease is in its early stages. They also can help slow the progression of Dupuytren’s contracture.

But, if the thickened tissue has already formed, or the fingers are already starting to curl, steroid injections don’t seem to be particularly effective.

Enzyme Injections

Your doctor may also try injecting an enzyme mixture into the thickened tissue to try and loosen it up. After the injection, doctors sometimes try to stretch and straighten out the fingers.

Enzyme injections can be effective, but most people require two to three of them before they see improvement. They also come with some minor side effects like swelling, bruising, and bleeding.

Less Effective Treatment Options

Some doctors recommend treatments like low energy radiation, ultrasound, or Vitamin E cream to treat Dupuytren contracture. These treatments are not well researched and generally are not as effective as the options mentioned above.

It’s also important to avoid splinting your fingers. It might seem like a good idea to force the fingers to straighten. But, the force from the splint can actually backfire and cause the finger to curl inward faster.

Surgical Treatment Options

After trying nonsurgical treatment options, your doctor may suggest surgical intervention if your condition doesn’t seem to be improving.

There are three different types of surgery that doctors perform to treat Dupuytren contracture:

Needle Fasciotomy

Also known as a percutaneous needle fasciotomy or a needle aponeurotomy, this is an outpatient procedure that is performed with just a local anesthetic.

During this procedure, the doctor will insert a fine needle or very sharp blade into the connective tissue of the palm or fingers. They’ll then use the needle or blade to divide the bands and release the tension that causes the hands to curl.

Some of the benefits of this procedure include:

  • Fewer deformities of the hand
  • Faster recovery
  • Low risk of complication

A needle fasciotomy is also a good option for older patients for whom extensive surgery is not safe.

Open Fasciotomy

Another option is an open fasciotomy. This procedure is usually used for more severe cases. There is more long-term relief from an open fasciotomy compared to a needle fasciotomy, but it’s also more extensive.

An open fasciotomy is an outpatient procedure, like a needle fasciotomy, and it’s performed under local anesthetic.

During this procedure, the doctor will create an incision to access and divide the thickened connective tissue to improve your ability to straighten your fingers. They’ll then seal the wound with stitches and apply a dressing.

Since the wound is larger from this procedure, recovery time is a bit longer. You’ll also need to plan for a second appointment to have the stitches removed, and you’ll likely have a scar left over.


The most invasive surgical option for Dupuytren contracture involves removing the thickened bands of tissue altogether.

There are three different variations of a fasciectomy:

  • Regional: The doctor removes the affected connective tissue through one large incision
  • Segmental: The doctor removes small segments of tissue through one or more small cuts
  • Dermofasciectomy: The doctor removes affected connective tissue and overlying skin that may be damaged, then seals the wound with a skin graft

Unlike the other two options, a fasciectomy will most often be carried out under general anesthetic. You’ll be unconscious during the procedure and won’t feel any pain.

Because of the use of general anesthesia, there are more risks that come with a fasciectomy. But, complications are still unlikely, and the results of a fasciectomy usually last longer than the results of a needle or open fasciotomy.

Potential Complications

Complications are quite rare. But, the most frequently experienced ones include:

  • Infection
  • Potential nerve or blood vessel injury
  • Permanent stiffness in the fingers

In the months following your surgery, it’s common to experience some swelling and discomfort.

Recovering from Hand Surgery

Most people see significant improvement in the range of motion in their fingers following surgical intervention, especially with the help of physical and occupational therapy.

After surgery, you’ll probably be able to return to your daily activities, including driving, after about three weeks. Recovery can be a bit longer for people who have had skin grafts.

You should refrain from heavy manual labor and intense physical activity for about six weeks to ensure proper healing.

Chances of Recurrence

Surgery is highly beneficial, especially for people who are experiencing limitations in their daily activities as a result of Dupuytren’s contracture.

However, it’s important to note that there is a chance that the condition will return. People with a strong family history or those who had particularly severe contractures are more likely to experience a recurrence after surgery.

The chances of recurrence are also higher in needle fasciotomies than fasciectomies. Dermofasciectomy has the lowest risk of recurrent (less than one in ten).

Get Treatment for Dupuytren’s Contracture Today

Do you think you’re suffering from Dupuytren’s contracture? Are you looking for treatment and relief from your symptoms?

If so, contact us today at Arora Hand Surgery to schedule a consultation. We proudly serve people throughout the state of Michigan, and we’re eager to help you improve your symptoms and start feeling your best.

Conditions General Hands

Dupuytren’s Contracture: What You Should Know

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Dupuytrens Contracture is a rare type of hand disorder that tends to take a number of years to develop. It causes the layers of tissues that lay beneath the skin on the palm of the hand to begin to form knots. These knots thicken and can actually cause one or more of the fingers to bend. Once they are bent into this position, it will no longer be possible to straighten them. Since it is impossible to bend the fingers, it will make it difficult to do many normal activities and actions. You would not even be capable of putting on a pair of gloves. Eventually, it will become difficult to grasp large objects.

In most cases, only the ring finger and the pinky will be affected. In very rare cases, it can also affect the thumb and the index finger. The contracture tends to affect older men who have a Northern European heritage.

What Are the Causes?

Currently, the cause of Dupuytrens Contracture is unknown. Researchers have not been able to find any evidence that it is related to hand injuries or any occupations that could cause repetitive stress issues or injuries due to vibration. However, they have found a number of factors that can increase the risk of developing the condition.

Men, as mentioned are the most likely to develop the contracture, and it typically affects those who are 50 and over. The condition also tends to run in families. Those who have diabetes are also at an elevated risk. In addition, smoking can increase the risk of developing Dupuytrens Contracture, as can alcohol.

Talking With a Doctor

Chances are good that you will want to speak with a specialist about this condition. Your primary care physician can refer you to a specialist, who will want to know more about your medical history and how you have been dealing with the condition. For example, they want to know whether there is a history of Dupuytrens Contracture in your family, if youve tried any treatments, and what medications you are taking.

The doctor will also want to know when the symptoms first started. Since this condition comes on slowly, it can be difficult to pinpoint when it began. Let them know if you are in pain, if the condition has been getting worse, and how it currently affects your daily life.

Most of the time, the doctors will be able to diagnose you based on examining your hands. The signs of Dupuytrens Contracture are very obvious.

What Are the Treatments?

Doctors can help to treat the condition in a number of different ways. They may use a needle technique, in which the doctor will insert a needle into the affected area to break up the hardened tissues that is causing the finger to contract. They may also utilize enzyme injections. Those who have advanced stages of the disease can also have surgery to help remove the hardened tissue.

If you suffer from Dupuytrens Contracture, speak with a doctor about your condition to find the best treatment options.

Conditions General

Understanding Dupuytren’s Contracture

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If you feel a tightening in your hands, or if from time to time your hands cramp up for no apparent reason, the cause could be Dupuytren contracture. This is a tightening in the fascia of your hands. Fascia are fibrous tissues that are located inside the palms of your hands, and progressive tightening can eventually result in difficulty using the hand along with an unsightly, claw-like appearance as your fingers begin to curl inward.

Diagnosing Dupuytren Contracture

As you might expect, diagnosis of Dupuytren contracture is done by examining the hand. During the examination, the doctor will usually find a tender nodule in the neighborhood of the third or fourth finger, in the palm. Initially, this nodule may cause pain, but eventually it will go away as the fingers begin to curl inward.

In order to effectively confirm or rule out Dupuytren contracture, your doctor will also take a complete history to determine if there is anything in your medical background that could be connected with the condition. If you consume excessive amounts of alcohol, or if you have diabetes or epilepsy, you are at a higher risk for Dupuytren contracture, although these are simply factors that seem to go hand in hand with Dupuytren contracture – the actual causes of the condition are not known.

What is known is that the condition appears to be hereditary, is more common in men than in women, and usually appears after the age of 45. There also appears to be a genetic component, but having the genetic makeup that is present in Dupuytren contracture sufferers does not necessarily mean that you will develop the condition. Approximately 5% of Americans have Dupuytren contracture. In about half of cases, both hands are affected. Interestingly, when the disorder affects only one hand, it is twice as likely to be the right hand.

Treating Dupuytren Contracture

If the condition is identified before the fingers start to curl inward, injection of a corticosteroid can relieve the symptoms. It is important to note, though, that this will simply ease the symptoms – it will not halt the progression of the condition.

Occasionally, Dupuytren contracture will go away without treatment, but usually at some point surgery will be required. Even after surgery, hand function may be limited. This is because removing the diseased fascia is not an easy procedure – the fascia protects a multitude of blood vessels, nerves and tendons, so the hand surgeon has to err on the side of caution.

The Final Word

If you are experiencing any of the symptoms of Dupuytren contracture, it is important that you see a competent hand surgeon in order to determine if the cause is actually Dupuytren disorder or due to some other condition. Then you can work together to agree on a course of treatment, which could include corticosteroid injections, and which may or may not include surgery. Although Dupuytren contracture does sometimes simply go away without treatment, that is the exception, not the rule.

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.