Restoring the function of the hand as much as possibleDupuytren’s contracture can nowadays be treated effectively using different therapeutic approaches.
Alongside Dupuytren surgery, our specialists at Schoen Clinic also offer minimally invasive Dupuytren treatment. As part of minor procedures, we can often eliminate growing connecting tissue strands in your hand through the use of medication or fine needles as well.
Conservative treatment methods
Dupuytren’s contracture treatment: new treatments as alternatives to Dupuytren surgeryTwo minimally invasive outpatient procedures are available for your Dupuytren treatment.
If the connecting tissue strand is very pronounced and clearly felt, our hand surgeons can treat this using medication (collagenase/enzyme treatment). The enzyme collagenase is injected directly into the thickened connecting tissue strand to weaken it
After 24 hours, the strand is weakened so much that the hand surgeon can break it using targeted over-stretching of the palm. You’ll only need to come into the hospital briefly on two consecutive days for this treatment. You won’t need any anaesthetic or have any open wounds. Your hand will have a splint for a day, and you’ll already be able to fully use it again the next day.
Crookedness in the base joint and a clearly noticeable connecting tissue strand can also be treated using a fine needle (PNF stretching/needle fasciotomy). Under local anaesthesia, we prick the connecting tissue strand through the skin. This can then be weakened through enzyme treatment for example and even broken.
However, half of patients continue to have issues after outpatient treatment around three years later. So an individual decision will also need to be made about what treatment methods are currently most suitable for improving your quality of life.
Surgical treatment methods
Dupuytren’s contracture: surgery using new methods, not outdated onesIn the initial stages of the disorder, the connecting tissue strands typically aren’t very noticeable. Surgery should continue to be delayed as long as there is no limitation in movement. However, if you start to experience limitations in finger movement, or if the hands are severely crooked because the disorder is already advanced, then surgery is the best and safest treatment in the long term. But a Dupuytren operation involves staying in hospital and takes longer to recover from. After surgery, your hand will need to be immobilised for some time. You’ll have a splint fitted that you’ll need to wear for the first two weeks after the operation date, 24 hours a day. For an additional six months, you’ll need to wear it at night. However, just one or two days after surgery, the splint will be removed for training purposes so you’re able to move your fingers and hand again as soon as possible. Our therapists will demonstrate targeted exercises to carry out at home, and after around six to eight weeks, you’ll be able to use your hand again to its full extent.
Outpatient treatment is quicker, but the patient will also recover more quickly with us, as a follow-up procedure will likely be needed.
Dr. Bernhard Lukas, Head consultant at Schoen Clinic Munich-Harlaching