Treating Dupuytren’s Contracture
Dupytren's contracture is a condition affecting the fingers and palm of the hand. Abnormal collagen build-up forms “ropes” or “cords” that begin to pull and curl the fingers inward toward the palm. In some cases the rope or cord can be felt or even seen. Although Dupuytren's progresses at a different rate in each person, it can worsen over time, leaving some people with bent fingers that need to be straightened by a doctor.
There are three common medical treatment options that a qualified orthopedic hand specialist doctor may recommend. Our hand specialist is board certified, fellowship trained orthopedic surgeon Nicholas M. Halikis, MD. He performs all three procedures. You can make an appointment with Dr. Halikis to find out more about your hand problems.
1. Injections of collagenase clostridium histolyticum, an enzyme medication
A needle is injected into the hand's collagen cord caused by Dupuytren's. The cord must be able to be felt in order to have this treatment. The medication partially dissolves the cord in approximately 24 hours, at which time the doctor breaks the cord in a next-day appointment. Because this treatment involves a medication, the FDA requires that only one section of one cord can be treated at a time. A single cord section may require up to three treatments, but most require one or two. Each injection takes just a few seconds. They must be spaced at least 30 days apart.
Dr. Halikis has treated many patients using these injections and has seen very good results. Because he is a highly experienced and prestigiously trained hand surgeon, he has been able to use his years of knowledge and experience treating Dupuytren's contracture to:
give the injections with accuracy
properly break the collagen cords
accurately assess the need for further treatment
provide a customized hand therapy plan for each of his patients
While any medical doctor can spend a small amount of time getting online training to administer these enzyme injections, not all are hand experts. Dr. Halikis has not only completed that training, he is also highly qualified to diagnose and treat Dupuytren's in other ways.
2. Needle Aponeurotomy
A needle is inserted into the hand to break the cords caused by Dupuytren's. This must be done by a highly skilled hand surgeon. More than one cord and section can be treated at once, including on both hands. It takes 10-20 minutes. Dr. Halikis has performed many needle aponeurotomy procedures and has also seen very good results in his patients.
3. Hand Surgery (Palmar Fasciectomy)
Patients who undergo this type of open hand surgery do so when enzyme injection or needle aponeurotomy is not the best option, such as when there are severe Dupuytren's symptoms in the knuckle in the middle of a finger, or when hand function is very limited. Recovery time is longer because surgery is more invasive than other treatments. Sometimes a skin graft is necessary. Dr. Halikis is an expert hand surgeon with very high success rates. He only recommends surgery when he determines it is absolutely necessary to significantly improve the patient's health or lifestyle.
See orthopedic hand specialist Nicholas M. Halikis, MD for the treatment that's right for you