Dupuytren’s Disease

What is Dupuytren’s disease and how is it treated?

Dupuytren’s disease is a progressive condition that affects the palmar fascia of the hand, leading to thickening and contraction of the subcutaneous connective tissue.
This process causes the formation of nodules and fibrous cords that can pull the fingers toward the palm, limiting the ability to fully extend the affected digits.
Dupuytren’s disease is more common in men over the age of 50 and can significantly impair hand function.

Symptoms:
Early symptoms include the development of small, firm, and painless nodules in the palm.
As the disease progresses, these nodules can develop into fibrous cords that cause the fingers—most often the ring and little fingers—to bend toward the palm.
This may result in a permanent flexion contracture, making daily tasks such as grasping objects or wearing gloves difficult.

Causes:
The exact cause of Dupuytren’s disease is not fully understood, but there is a strong genetic component, as the condition often runs in families.
Other risk factors include advanced age, male gender, excessive alcohol consumption, and smoking.
Dupuytren’s disease is also associated with certain medical conditions such as diabetes and epilepsy.

Diagnosis:
Diagnosis is based on a detailed physical examination of the hand.
The physician evaluates the presence of nodules and fibrous cords, and assesses the ability to fully extend the fingers.
In some cases, imaging tests like ultrasound may be used to determine the extent of the disease.

Treatments:
Treatment depends on the severity of symptoms and the functional limitations caused by finger contracture.
In the early stages, when symptoms are mild, observation and monitoring may be sufficient.

In more advanced or symptomatic cases, several treatment options are available:
Corticosteroid injections can help reduce pain and inflammation in the nodules.
Another non-surgical option is the use of collagenase injections, where an enzyme is injected directly into the cord to break it down, allowing greater finger extension.

In severe cases, surgical intervention may be necessary to release the fibrous cords and restore hand function.
This may involve a fasciotomy (cutting the cords) or fasciectomy (removal of the affected fascia).
Depending on the severity and patient preference, surgery can be performed using traditional or minimally invasive techniques.

At Handclinic, under the care of Dr. Marco Guidi, we offer a personalized approach to treating Dupuytren’s disease, combining advanced techniques and specialized care to improve hand function and enhance our patients' quality of life.