Tuesday, October 30, 2007

Dupuytren's Contracture

Click to enlarge
About 4 or 5 years ago, I developed a condition whereby my small finger on my right hand would not straighten out completely. I visited my doctor and he diagnosed it as a condition called Dupuytren's Contracture (pronounced "doo-PAY-trens"), also called Dupuytren's Disease. He referred me to a plastic surgeon in our area. The photo to the right is of my right hand, palm up, showing the small finger.

The surgeon said it could be fixed with surgery, but the surgery was not without risk – in fact, he said there was a 15% possibility of permanent nerve damage. I did not like the odds, and since the condition was not painful, I chose to not have surgery and live with it. For the most part, it did not impact my day to day life in any way.

However, earlier this year, it began to bother me somewhat. Not so much pain, although it did hurt a bit if pressure was put on it in the area of my palm just behind the finger, but not on the finger itself. No, it was more a nuisance. Because of the continued curvature of the finger, it tended to get caught on things like when I put my hand into my pocket, or when washing my face it snagged on my nose (I know, sounds gross, but on several occasions I ended up with a bleeding nose because of it.)

So I started doing some research on the net. I found that there was a relatively new procedure called Needle Aponevrotomy, or NA for short, that was much less invasive than major surgery. Developed in Paris, very few doctors in North America were practicing it. I found a Dr. David Kline in Oregon that had a clinic to do the procedure and was seriously considering going down there to have it done.

Then, after doing some more research, I found a Dr. Paul Binhammer right here in Toronto that also was doing NA at the Sunnybrook Health Sciences Centre, about a 20 drive from my home. I immediately contacted my doctor to have him arrange an appointment for me. That was back around February.

I finally got to see Dr. Binhammer yesterday, and it looks very promising. He said that he could do the NA procedure in his office and it would take about 20 minutes. Then, I would need to go down to the splint department, where they would make a custom splint for my hand. This splint is to be worn each night when I sleep for the next 3 months. It is not needed during the day, and supposedly I will have full mobility in the hand immediately after the procedure. The cost of the entire procedure is covered by OHIP (the Ontario Medicare program); the only thing that is not covered is the cost of the materials required to make the splint.

He pointed out that the NA procedure does not remove the diseased tissue, but cuts the fibers allowing the finger to straighten. There is possibility the condition will return a few years down the road, in which case, he could perform an operation to remove the diseased tissue. He said he could do this operation now instead of NA, but left it up to me to make the decision. I said I thought the NA procedure would be the best choice first, and if needed, I could come back for the operation.

He said I can expect a call from his secretary to set up an appointment for the NA procedure, which I am hoping will be soon, and I will not have to wait another 8 or 9 months.


Blogger John Robertson said...

I just read your blog on Dupuytren's Contracture and thought you might be interested in knowing about the latest possibility for help. There is clinical studies going on that is showing good relief from the problem. They are just starting third stage clinical studies and it will probably be about two years before the product hits the market. But it is something I have been following for the last couple of years. I have chosen not to have any operations on my hands. I have four fingers and both thumbs with the disease and they don’t function very well. As my doctor says” they aren’t the Guinness Book of Records hands but they sure are close. (for photos of my hands you can see them on my blog page; http://www.whatartdidhemaketoday.com/2007/10/dupuytrens-contracture-hand-art.html

For more info about the clinical studies here’s a link to the US gov. site http://www.clinicaltrials.gov/ct/show/NCT00528606?order=2. You can also do a search on Auxilium Pharmaceuticals which is the one developing the Clostridial Collagenase for Injection.

All my best to you,

John Robertson

7:36 p.m., October 30, 2007  
Anonymous Anonymous said...

Very interesting data, wish there was more here on your blog. Tired of only looking at studies and health material because since this is not a life threatening disease and since there is no big money in it, as well as being somewhat rare statistically.

That being said, I am a rare case, I am 44 now, I got this in my left hand and was diagnosed when I was about 15 and it really did not progress rapidly until I was early 30's. My left hand was operated on about 4 to 5 years ago and now it has come back in force in my left hand, it has entered my right hand and is growing at 10xs he rate in my right hand, and now I have a location in my foot, although it is not drawing in my toes. My hands over the last several months hurt a great deal and many simple tasks make me realize this problem is there and in front of me!!
I hope that some solution to work on this is coming soon, and look forward to more research. If you have any great clues to new alternatives to surgery, etc. let me know. My email is at yahoo and it is jpm.shamrock, so yes, I have all the symptoms of the heritage for this problem, but know of nobody else in the family that had it. Thanks, better hands to everyone reading!!

8:39 p.m., February 21, 2008  
Anonymous Anonymous said...

You might have a look at web site on Dupuytren's contracture. That site gives an overview on currently available therapies for Dupuytrens, including collagenase.


8:26 a.m., March 05, 2008  
Anonymous Anonymous said...

I have had great success with the needle aponuerotomy procedure. Dr Lewis at the Orthopedic Center in Walnut Creek, CA performed the procedure. It took 15 minutes with minimal pain. I am thrilled to have found a doctor in the area who is trained in this procedure. It is a great improvement over the standard procedure and results in almost no recovery time. See his web site "dupuytrens.biz"

12:27 a.m., March 18, 2009  
Anonymous judy perry said...

I have had the contracture in my little finger and ring finger for 4 years.. I was just about to contact a surgeon for the needle treatment... when a friend of mine mentioned trying castor oil ... for 4 nites now i have been putting castor oil.. cold pressed, odorless, from the health food store... on my hand putting latex free plastic glove and rubber band over it and sleeping with it on all nite... from the first nite I am getting results.. the fingers when I get up are more relaxed, not red as they have been... and each day I can lay my hand down flatter.. by the end of the day i can feel it trying to tighten up but then by the next morning it is a little straighter! I will continues with these treatments, it is a miracle!

9:47 p.m., October 23, 2011  
Anonymous Anonymous said...

Judy, thank you for your interesting idea on castor oil. I have been putting hand cream, lots of it, on my hands at night, also, and I had wondered if castor oil would help more. Castor oil came to mind because it's the greasiest thing I could think of!
Please let me know if it works for you!! I am 66 years old, female, definitely NOT an alcoholic, and don't know of anyone in my family who has ever had the disease. I have the knots in my palm but so far no contracture of my fingers. My fingers hurt, though, and palms are sensitive to pressure. Have seen two "hand specialist" surgeons who just tell me to come back when my fingers are bent. I don't want to get that far; I want help now. So, please continue to post comments about your progress with the castor oil.
Thank you very much,

10:43 p.m., January 23, 2012  
Blogger Joe Chernabaeff said...

My mother and I both have Dupuytren's disease, and I also have Ledderhose disease. My mother had surgery on her hands once, what an awful experience, plus, her condition came back. In our quest to find some sort of relief, we tried all sorts of pain killers, & home remedies. I found something that has subsided the inflammation in my feet, and my tumors have reduced dramatically in size. Also the conditions of the Dupuytren's in my mother and I decreased so dramatically we now have full range motion in our hands, and know we are both pain free and living a normal life. Let me show you what we have found please email me at gchernabaeff@gmail.com

1:45 p.m., March 05, 2013  
Anonymous Michaela said...

Scientists recently discovered that gluten free diet is very important. I suffer from Dupuytren's Contracture as well.

5:16 a.m., July 10, 2014  

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