In the Jul/Aug 2010 issue of the Post, a reader asked the following question, which we addressed in our Medical Mailbox section. For our online readers, we offer this related update on Dupuytren’s contracture: “New Hand Therapy”
Q: The little finger on my left hand kinks up into a hook. Is this problem caused by arthritis? I can hardly tie my shoes. Please advise.
Blooming Prairie, Minnesota
A: [Cory SerVaas, M.D., and Wendy Braun, R.N.] Your symptoms match those of Dupuytren’s contracture, a sometimes disabling (but not dangerous) condition that pulls fingers toward the palm and locks them there. It’s unrelated to arthritis. “Dupuytren’s causes painless contraction of fibrous tissue directly under the skin of the palm and fingers, and may be associated with nodules or cords in the palm. Over time, an affected finger may bend into a hook,” notes Dr. Taizoon H. Baxamusa, who is affiliated with the University of Illinois at Chicago and the Illinois Bone & Joint Institute in Morton Grove. “The cause of Dupuytren’s is not known; however, there is a strong hereditary association, especially among people of Northern European or Scandinavian descent. It’s more common in men than women, and risk increases with age.
“Dupuytren’s is sometimes confused with trigger finger, tendonitis, or arthritis. Try this simple test: Place the hand and fingers flat on a tabletop. If you are unable to do so, or the finger curls under, you may wish to seek a formal evaluation by an orthopaedic surgeon.”
New treatments include nonsurgical needling techniques and injections of the biologic drug Xiaflex.