DEAR DR. GOTT:
I am a 70-year-old male. I have developed Dupuytren’s contracture in my left hand affecting the little finger. My hand doctor told me it is stage one and recommended surgery. I am hesitant to have any surgery as I play the guitar and am concerned with possible complications.

I have done minimal research and found that there is a non-invasive procedure called “needle aponeurotomy” that has little or no complications. Do you think this procedure is a viable alternative?

DEAR READER:
Dupuytren’s contracture is a common malady of the hand that causes the connective tissue of the palm to contract. Over time the tissue then toughens and can form lumps, knots and cords. Most people also experience bending of one or more the fingers as the tissue tightens. The little finger is most commonly affected with the ring and middle fingers also affected in more severe cases.

Closing the hand remains unaffected. The fingers that are pulled by the tissue take on a bent appearance and cannot be straightened. Often the Dupuytren’s is not painful but the knots of tissue on the palm may be sensitive to touch.

Most cases of Dupuytren’s progress slowly, often over several years. In some cases, the progress may take only months. Some experience progressive worsening while others may have only minimal damage which then stops on its own. [Read more...]

DEAR DR. GOTT:
I’m a 48-year-old, very active male with more things to do than I have time for, but, apparently my time is running out. Two years ago I was diagnosed with Dupuytren’s contracture. It’s growing fast and I’ve found out no one will do any preventive surgery until I can no longer function. Bologna! Why do I keep getting the same response? Is there anyone who can help me? I don’t want to wait until I can’t function. My hands and palms ache. Any suggestions?

DEAR READER:
As with any surgery, the benefits must outweigh the risks and apparently your condition is not yet severe enough to justify an aggressive approach.

Dupuytren’s is an abnormal thickening of the tough tissue under the skin of the palm of the hand and fingers. The thickening causes the fingers to curl toward the palm; the ring and small fingers are most commonly affected. The condition often begins as a small lump in the palm, has no known cause and is not preventable. It can be treated by physical therapy in its early stages.

If you have seen surgical specialists who feel your condition is not severe enough to warrant surgery, I suggest you accept the recommendation. Make repeat visits as your condition progresses. Then be guided by the best suggestions for treatment.