Dupuytren’s disease is a condition of the hand which leads to progressive flexion of the fingers. The condition is fibrotic in nature.
It was first described by Baron Guillaume Dupuytren in The Lancet in 1831. It was thought to have been introduced into Anglo-Saxon races by the Vikings in 700AD. It remains almost exclusively a caucasian disease and is genetic. Generally it appears later in life.
Currently Dupuytren’s disease cannot be cured, but bent fingers can be straightened.
Early nodules within the palm are not treated surgically. These may be treated with steroid injections if they are painful or left alone. Surgery is contemplated when your hand can no longer be placed flat on the table or when the first knuckle drop of the finger (PRP joint) starts becoming bent. The exact timing of this is important. This will be discussed with you by Mr Kenton-Smith.
Surgery is usually performed under a general anaesthetic or arm block anaesthesia as a day surgical procedure in St Georges Hospital or Southern Cross Hospital.
A zig-zag incision is made over the chords and bands and these chords and bands are separated from the nerves and blood vessels of the finger under magnification. If the skin of the finger is involved, Mr Kenton-Smith may perform dermofasciectomy where the involved skin is removed and replaced with a skin graft. This is usually taken from the palm of the hand. This appears to reduce the rate of recurrence of Dupuytren’s.
Since the underlying condition cannot, at this stage, be cured, Dupuytren’s often recurs. Hopefully, this will be many years in the future. Recurrent Dupuytren’s is generally amenable to further surgery.
Approximate cost for the procedure is between $5,000 and $6,500.