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Treatments
Surgical
Non surgical
The good news is that Dupuytren's Disease is treatable! The bad
news is that it is not curable at the moment. I prefer to talk in
terms of controlling Dupuytrens. Every patient with Dupuytren’s will
experience recurrence after treatment or extension into another area
of the hand. If you are lucky and have a mild form of the problem
this might not be for 20 years. For some people this might be very
rapid - 6 months.
There are a large number of treatments available for Dupuytren’s
which have developed over time. These range from the legendary
(letting a bishop kick your hand) to the barmy. Most techniques
today depend on some form of surgical intervention allied to
splintage which we believe slows down the rate of recurrence
although we have no evidence to support such a view!
Surgical techniques have ranged from simply cutting the band in the
palm, originally described by Sir Astley Cline to major surgical
interventions, removing significant amounts of the diseased skin and replacing it
with skin grafts. Like most areas of surgery interest is slowly
increasing in less interventional techniques such as Needle
Aponeurotomy and most recently experiments have been carried out to
see if injecting enzymes into the cord is effective in breaking them
down.
Like any other form of surgery you should check how often your
surgeon carries out the planned operation and the possible
complications. For Dupuytren’s surgery I would have no hesitation in
stating that your surgeon should be a specialist in Hand Surgery.
This is not the place for a general Orthopaedic or Plastic Surgeon,
your hand is too important.
To find a surgeon you can look on the British Society for Surgery of
the Hand website, the Society do not offer any guarantee of ability
but all members have expressed an interest in Hand Surgery and carry
out a substantial amount in their NHS practise.
All surgeons in the UK carry out fasciectomy in one of its forms but
very few carry out NA. At present we know of only one surgeon doing
NA in the UK in the fingers, if you have had NA carried out by a
British surgeon, please let us know.
Radiotherapy is carried out in Europe for Dupuytrens disease but we
know of no UK units offering such treatment, again please let us
know if you hear differently.
Surgical
The Bainbridge Hand Clinic protocol
Non Surgical
Collagenase, Xiaflex, Enzyme injection.
Steroid injection
Radiotherapy
Complementary