Author Topic: Dupuytren's contracture  (Read 2282 times)

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Offline 4nthony

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Dupuytren's contracture
« on: August 23, 2022, 12:08 AM »
Anyone familiar with it?

It's one of those medical conditions that hits in middle-age with a mostly unknown cause, though it seems to be hereditary. It causes a tightening of the skin in your palm and prevents your ring and/or pinky finger(s) from fully extending.

I've got it in both hands (left is worse than right) and will be meeting with a hand surgeon tomorrow to discuss some options.

About 8-10 years ago, I remember the beginnings of a bump forming near the knuckle.

On my left hand, this is as far as my pinky finger will extend. You can also kinda see the hard skin, that is kinda like large calluses. I have both hard skin on the surface and large bumps under soft tissue. Other than limiting the use of my hand -- it makes yoga, pushups, and other exercises that require a flat palm more difficult -- it isn't painful. Though, sometimes my pinky finger hits or gets stuck on things. I suspect this is because my brain still doesn't realize my finger isn't fully extended and muscle memory thinks there's room to get around any obstacles.

Anyhow, just curious if anyone here has it or has had it treated and what your outcome was. There's a procedure called "Needling" where they basically take a needle and stab the hard skin to divide it and release the tension. I'm hoping that will work as I'd rather not go under the knife.



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Anthony

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Offline Cheese

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Re: Dupuytren's contracture
« Reply #1 on: August 23, 2022, 09:31 AM »
My sister started to get it in both of her hands when she turned 65. Both hands have been operated on and they're now as good as new. I'll ask her about any issues/problems.

Offline bobtskutter

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Re: Dupuytren's contracture
« Reply #2 on: August 23, 2022, 03:24 PM »
Someone I work with had this happen to one of his fingers.  The finger ended up folded over onto his palm.  He needed a piece of skin to be removed and then a skin graft to replace the missing tissue.  He never regained the use of his finger.  The specialist told him he should have got it seen to earlier.  Please go and see your doctor.
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Bob

Offline 4nthony

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Re: Dupuytren's contracture
« Reply #3 on: August 23, 2022, 08:31 PM »
I met with the surgeon today and my four options are:

- Do nothing and just live with it
- Needling, but it's not recommended because the contraction is very close to nerves and the "stabbing" of the needle is done without knowing where the nerves are. Each stab could potentially hit a nerve.
- Xiaflex injection, but it has a lot of really bad side effects
- Surgery, but there's a potentially long road to recovery, along with a chance of infection, nerve, and tendon damage. At least in surgery, the surgeon can see where the nerves are.

I scheduled the surgery just to get on the list, but I can cancel if I change my mind between now and then. Right now, I'm leaning toward surgery. The idea of the injection and its side effects are not appealing but I'll have to give this some real thought before deciding.

@Cheese - Looking forward to hearing any thoughts your sister might have.

Thanks!

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Anthony

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Offline luvmytoolz

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Re: Dupuytren's contracture
« Reply #4 on: August 23, 2022, 11:02 PM »
What about the enzyme injection option?

Offline 4nthony

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Re: Dupuytren's contracture
« Reply #5 on: August 23, 2022, 11:15 PM »
What about the enzyme injection option?

This paper mentions "enzyme injection" then continues with "clostridial collagenase injection" which is what Xiaflex is.

So I think they are considered one and the same.

My wife is really pushing for the injection. If the Xiaflex fails, surgery would still available as an option. As for the side effects, they might not be as bad as I originally thought.

Though, still a little spooked by all this.
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Anthony

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Offline Crazyraceguy

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Re: Dupuytren's contracture
« Reply #6 on: September 05, 2022, 03:40 PM »
I had never heard of it until I saw it advertised on TV. Payton Manning?
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Offline afish

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Re: Dupuytren's contracture
« Reply #7 on: September 05, 2022, 05:29 PM »
What about the enzyme injection option?

This paper mentions "enzyme injection" then continues with "clostridial collagenase injection" which is what Xiaflex is.

So I think they are considered one and the same.

My wife is really pushing for the injection. If the Xiaflex fails, surgery would still available as an option. As for the side effects, they might not be as bad as I originally thought.

Though, still a little spooked by all this.

Getting old sucks...

Offline Richard/RMW

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Re: Dupuytren's contracture
« Reply #8 on: September 05, 2022, 06:13 PM »
What about the enzyme injection option?

This paper mentions "enzyme injection" then continues with "clostridial collagenase injection" which is what Xiaflex is.

So I think they are considered one and the same.

My wife is really pushing for the injection. If the Xiaflex fails, surgery would still available as an option. As for the side effects, they might not be as bad as I originally thought.

Though, still a little spooked by all this.

Getting old sucks...

Yet it beats the alternative...

RMW
As of 10/17 I am out of the Dog business and pursuing other distractions. Thanks for a fun ride!

Offline 4nthony

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Re: Dupuytren's contracture
« Reply #9 on: September 05, 2022, 07:43 PM »
Getting old sucks...

Between this hand thing, the arthritis in the knees, and the constant need for reading glasses...it feels like next week I'll be reaching for a walker.

 [scared] [crying] [big grin]
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Offline Cheese

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Re: Dupuytren's contracture
« Reply #10 on: September 05, 2022, 08:58 PM »
Getting old sucks...

True...but being dead really sucks.  [big grin]

Offline rvieceli

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Re: Dupuytren's contracture
« Reply #11 on: September 05, 2022, 09:02 PM »
Every morning I wake up is a good day.  [big grin]

Ron

Offline Cheese

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Re: Dupuytren's contracture
« Reply #12 on: September 08, 2022, 01:09 PM »

@Cheese - Looking forward to hearing any thoughts your sister might have.


I talked with my sister @4nthony  and she had both hands done. One about 10 years ago and the other about 4 years ago. She said she'd do it again in a heart beat. She was in her 60's when she had the surgery completed.

Her husband drove her to the surgery, it took about 2 hours and she then had 5 weeks of physical therapy but only 1 hour per week. They made a "cast"and she wore the cast when she was sleeping to prevent the fingers from curling again. So that was 5 weeks of also sleeping with the cast on. She did not wear the cast at all during the day. After the last physical therapy session, she threw the cast out and that was it. [smile]

Her only regret was not having the surgery sooner.

I'm sure that in 10 years the procedure has been improved.  [smile]

Offline 4nthony

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Re: Dupuytren's contracture
« Reply #13 on: September 08, 2022, 01:18 PM »
I talked with my sister @4nthony  and she had both hands done. One about 10 years ago and the other about 4 years ago. She said she'd do it again in a heart beat. She was in her 60's when she had the surgery completed.

Her husband drove her to the surgery, it took about 2 hours and she then had 5 weeks of physical therapy but only 1 hour per week. They made a "cast"and she wore the cast when she was sleeping to prevent the fingers from curling again. So that was 5 weeks of also sleeping with the cast on. She did not wear the cast at all during the day. After the last physical therapy session, she threw the cast out and that was it. [smile]

Her only regret was not having the surgery sooner.

I'm sure that in 10 years the procedure has been improved.  [smile]

Good to know, thanks buddy. After some additional consults, I've decided to go with the Xiaflex injection. It's possible that the condition will return and if that happens, then I'll opt for surgery.
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Offline Cheese

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Re: Dupuytren's contracture
« Reply #14 on: September 08, 2022, 01:28 PM »
Good to know, thanks buddy. After some additional consults, I've decided to go with the Xiaflex injection. It's possible that the condition will return and if that happens, then I'll opt for surgery.

Ya that's the route I'd also take, like I mentioned, the procedures probably get better every couple of years and the injection was not even available when my sister had her first hand done. The doctor offered her the option to operate or to just live with it. [huh]
Good luck, I hope the injection is the charm.  [big grin]

Offline 4nthony

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Re: Dupuytren's contracture
« Reply #15 on: October 25, 2022, 04:25 PM »
I had my Xiaflex injections this morning. I think there were about 10 or 11 shots total. After the first shot I couldn't keep count as it was easily the most painful experience I've ever had in my life. There's a bunch of nerves in the region and in addition to the pain, it was also causing me to twitch and jump like crazy. My finger is starting to swell and bruise as the collagen begins to break down.

I have to return on Thursday for another visit where he'll numb my hand and try to pull the finger straight, essentially tearing/ripping the weakened tissue.

Should be fun! [cool]

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Anthony

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Offline 4nthony

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Re: Dupuytren's contracture
« Reply #16 on: October 27, 2022, 04:53 PM »
Success.

My finger after the Xiaflex injections, then after the doctor numbed and massaged the collagen. I was was expecting the straightening of the finger to be painful but it was basically painless. I heard a bunch of cracks and pops as the collagen broke down. It felt like cracking my knuckles. I'll go back in a few months for my right hand.

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Anthony

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Offline Peter Halle

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Re: Dupuytren's contracture
« Reply #17 on: October 27, 2022, 05:18 PM »
Best wishes on a speedy and successful healing process!

Peter

Offline Picktool

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Re: Dupuytren's contracture
« Reply #18 on: November 20, 2022, 03:11 PM »
Article today in Washington Post - The ‘most common crippling hand condition’ you’ve never heard of

Haha... I recall my father had it way back. I thought it was because
he was an old school butcher and always holding a knife. Not sure if
he ever found out what it was as it didnt seem to be that much of a bother to him.

Well Dogey

Offline HowardH

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Re: Dupuytren's contracture
« Reply #19 on: November 27, 2022, 10:20 PM »
I had never heard of it until I saw it advertised on TV. Payton Manning?

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Offline 4nthony

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Re: Dupuytren's contracture
« Reply #20 on: November 27, 2022, 10:43 PM »
Article today in Washington Post - The ‘most common crippling hand condition’ you’ve never heard of

Haha... I recall my father had it way back. I thought it was because
he was an old school butcher and always holding a knife. Not sure if
he ever found out what it was as it didnt seem to be that much of a bother to him.

I saw that article last week and have been meaning to reply. Interesting stuff. I also signed up for the research group study mentioned.

Now that I'm a month out from the injection, my finger fully extends but I'm still having a hard time putting my hand flat on the floor while bending my wrist (think push-up position).

The injection broke down the collagen but it didn't fully dissolve it so it's still there. When it was compressed to break the cords, its like it was spread out. Kinda like what would happen when you flatten a ball of cookie dough. It also feels like there's more scar tissue as well. The nodules themselves aren't painful but if I grip something, I'll feel some pain. The doctor used the analogy of having a rock in your shoe, it's not necessarily painful until it's between your foot and the ground.

I'll see how things play out in the next 6-12 months and also see if the contraction returns. Then, I'll decide if I want to go back and have surgery to clean out the nodules.

If you look back at the first picture I posted, you can see how the nodules were closer to the #2 joint on my finger compared to below, where the nodule has been flattened and pushed toward the palm.

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Anthony

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