Dupuytrens Contracture

Subject: Dupuytrens Contracture
From: GUEST,Scorpio
Date: 28 May 09 - 02:41 AM

This is a disease which makes the tendons in the palm of your hand knot up and shorten. This pulls the fingers in towards the palm. Usually the ring and little fingers are the most affected. With me it's getting difficult to lift my little finger off the fretboard. A search on the net told me that an operation is usually successful, but recovery time is 6 months! Does anyone have any experience of this, alternative treatments, miracle cures?

Subject: RE: Dupuytrens Contracture
From: s&r
Date: 28 May 09 - 04:37 AM

A friend has this. He has had the operation with good success, but not permanent. However, the interval between operations has been a number of years, and the use of his fingers was much improved. Currently his little finger is inoperable and his consultant wants to remove it.

Not the best scenario, but the only instance i know 'second hand"

Hope yours is a mild case

Stu

Subject: RE: Dupuytrens Contracture
From: Newport Boy
Date: 28 May 09 - 01:26 PM

Anne has the condition, and has had two operations - one on each hand. The first was about 8 years ago on a ring finger and this has given no trouble since. The second one, about 5 years ago, was on both ring and little fingers of the other hand. This was not so successful (we're inclined to blame the particular surgeon - but that's just our opinion) and she's going in for this to be redone in about 2 months time.

She meets a guy swimming who has had more than a dozen operations over 20 years. After the particular op is done, he then has no problems with dexterity, but his always seem to recur.

I've not gone back to the web, where there's more information than you could ever read, but this is roughly what we've learned. I'm an engineer, not a medic, so some of my terms may be wrong.

1. It's been a well known condition for over 100 years, and the operation to relieve it is basically unchanged.

2. The cause is not known. It seems to be the growth of a layer, or sheet, of cartilege on the line of the tendons, just below the skin.

3. The operation basically scrapes away the layer of cartilege.

4. The condition may or may not re-occur in the same location. This semms to be random.

5. Talking of location - the hand is most common, but it also occurs in the foot and (for men only, obviously) in the penis. (Before you ask, I don't know which way it pulls that!!)

6. There are few complications - the operation is very common - but long-term success can't be guaranteed. However, repeat operations are also quite common, with a similar success rate.

7. There is an optimum period for the operation. First sign is inability to straighten the finger, even under pressure. The finger then gradually gets pulled towards the palm. The op needs to wait until the cartilege has built up sufficiently, and the usual criteria is when the finger has pulled to nearly 30 degrees from straight. It then needs doing fairly soon. If it's left too long, amputation is the only option if a permanently clenched fist is to be avoided (the affected finger will gradually pull the others).

Anne's experience is of an outpatient op with a local anaesthetic. The hand was fairly sore for a few days, but some limited use was possible after a week or so and reasonable function was regained in about 6 or 8 weeks.

Finally, no other treatments or miracle cures have been found in over a hundred years. If you don't want to lose the finger or use of the hand, have the surgery at the right time. Just pick a surgeon with a good record in this field.

Good luck, and I hope I've helped.

Phil


PS - the Trivia. Occurrence of the condition may indicate genetic descent from the Vikings.

Subject: RE: Dupuytrens Contracture
From: MartinRyan
Date: 28 May 09 - 02:01 PM

Further trivia: wasn't this mentioned in Patrick O'Brian's Aubrey/Maturin novels?

Regards
p.s and of course - best wishes for a benign prognosis.

Subject: RE: Dupuytrens Contracture
From: Newport Boy
Date: 28 May 09 - 02:16 PM

A couple of small corrections to my post above - my memory seems to fade with maturity!

Anne's ops were with a general anaesthetic - a possible local was mentioned on the one occasion, but she wasn't keen. She was in overnight the first time (our NHS) but was out same day with the second (a private hospital).

and her swimming friend has had 6 operations over 12 years (not 12 in 20).

Phil

Subject: RE: Dupuytrens Contracture
From: GUEST,Scorpio
Date: 28 May 09 - 03:10 PM

Thanks a lot, Newport Boy. You seem to have summed up most of what I read on the net, plus a whole bunch of personal experience which means the world to me. By the way, want to talk trivia? I come from Yorkshire, the Viking part of old England, and now live in Denmark! The rest of your list of characteristics had me down. I have knots in the tendons under my feet too. And some years ago the undercarriage also had simlilar problems. Went away thank God. The recidivist effect is high, but you console me with the recovery time. Thanks again.

Subject: RE: Dupuytrens Contracture
From: Newport Boy
Date: 28 May 09 - 05:19 PM

OK, Scorpio

PM sent

Subject: RE: Dupuytrens Contracture
From: katlaughing
Date: 28 May 09 - 06:28 PM

There are a few others who have this and/or have posted about it and treatment:

HERE and,

HERE and,

a little bit HERE.

Those are all from several years ago, so may be out of date. Good luck.

kat

Subject: RE: Dupuytrens Contracture
From: Mark Ross
Date: 28 May 09 - 07:52 PM

Utah Phillips had it, and had 2 or three operations to correct the problem. It was his left ring finger which made it hard to chord the guitar.

Mark Ross

Subject: RE: Dupuytrens Contracture
From: Sooz
Date: 29 May 09 - 03:58 PM

Mr Sooz has it - it is a genetic condition shared by both his dad and grandmother. He had his first operation 22 years ago this month and has had about seven more in the intervening years with some temporary success. The days following the surgery were extremely painful in every case, but more so when the operation was on the thumb. They put the hand in plaster while he was under the anaesthetic but unfortunately didn't give him another one three weeks later when they took it off (complete with embedded stitches.)
Playing the guitar every day is his physiotherapy and he has decided not to have any more surgery even though neither hand is remotely flat.

Subject: dupuytren's contracture again
From: GUEST,Scorpio
Date: 02 Jun 09 - 10:06 AM

Sorry, but I cant find my previous thread! I found a lot of older stuff though. Dummy that I am, I can't find out how to receive a PM either, and I think someone sent me one.

Subject: RE: Dupuytrens Contracture
From: bobad
Date: 02 Jun 09 - 10:18 AM

Scorpio, you must be a member to send and receive PMs. Why not join up, it's painless.

Subject: RE: Dupuytrens Contracture
From: Banjo-Flower
Date: 02 Jun 09 - 10:19 AM

To receive a PM you have to be a member

Gerry

Subject: RE: Dupuytrens Contracture
From: Deckman
Date: 02 Jun 09 - 11:11 AM

I also have it, but it not serious enough yet that I'm considering surgery. I have a very good hand surgeon. He's done two hand surgeries on me and one of "Bride Judy." All were successful. This surgeon, as well as other doctors, have ALL told me there is a strong ethnic connection with this situation. People from Northern Europe tend to develope this. I'm Finn, and I well know of other "Nordic gifts" such as goiters. These seem to be related to the older traditional diet relying heavily on course grains, such a rye. And yes, my late Father had it.

One test that my surgeon uses is this: place your hand flat on the table. If you can press it down hard so the entire palm meets the table, it's probably NOT time for surgery yet. If the "cupping" of your hand prevents this without a lot of pain, then you might need to socisder surgery.

Ain't life fun! CHEERS, Bob(deckman)Nelson

Subject: RE: Dupuytrens Contracture
From: Sooz
Date: 02 Jun 09 - 12:24 PM

Can't remember when Mr Sooz could put either hand flat on a table!

Subject: RE: Dupuytrens Contracture
From: JeffB
Date: 04 Jun 09 - 07:15 PM

Further trivia :-

There is a completely unfounded theory that an early Pope might have had Dupuytrens because the contracture of the fingers resembles the traditional way the Pope raises his hand in blessing.

The disease is often related to RSI. Dupuytrens was an 18th C surgeon who noticed that the whip hand of his coachman was deformed. The coachman was the first to have (an apparently sucessful) correction. Whether he was able to give anything like informed consent I rather doubt.

Subject: RE: Dupuytrens Contracture
From: Deckman
Date: 04 Jun 09 - 07:42 PM

RSI ... ??? bob

Subject: RE: Dupuytrens Contracture
From: s&r
Date: 05 Jun 09 - 02:52 AM

From an occupational health site re repetitive strain injury (RSI)

"The incidence of Dupuytren's contracture in a polyvinyl chloride (PVC) manufacturing plant, where a great deal of bagging and packing took place by hand, was higher than in another plant in which there was no bagging or packing. The incidence in the packing plant was double that found in an earlier survey by Early at Crewe Locomotive Works of 4801 individuals, most of whom were manual workers. The implication is that the nature of the work of bagging and packing in our PVC compounding plant may have triggered Dupuytren's contracture."

Stu

Subject: RE: Dupuytrens Contracture
From: Deckman
Date: 05 Jun 09 - 07:17 AM

TVM .... (thanks very much) CHEERS, Bob(deckman)Nelson

Subject: RE: Dupuytrens Contracture
From: GUEST,Ana
Date: 13 Jun 09 - 07:52 AM

I've recently been diagnosed too, so have been sussing out stuff - radiotherapy can apparently help in early stages.

Check out this

http://www.dupuytren-online.info/Radiation-therapy-for-Dupuytren-Judith.htm

Subject: RE: Dupuytrens Contracture
From: Rumncoke
Date: 15 Jun 09 - 08:36 AM

My father had this, though it never became so bad that he could not cope with everyday life.

My brother has recently noticed the start of the same thing, as yet it is only mild.

I had to tell him that it was hereditory condition, as my sister insists that it was due to an injury to our dad's hand.

I could suspect Viking ancestry, as I was born in York.

Fortunately I have reached the age of 58 years and my hands are still fully flexible - I can not only place my hand flat but raise the heel of my hand the width of two fingers whilst keeping my fingers flat down.

I do have a defunct thyroid - connection with goiter there.

I will pass on the information about radio therapy to my brother, as he hates doctors and will put off going until it is too late, I know, if operations are at all possible.

Anne Croucher

Subject: RE: Dupuytrens Contracture
From: Jack Campin
Date: 15 Jun 09 - 08:58 AM

Margaret Thatcher had it. Presumably there's a genetic link with wholesale pillage and destruction as well.

Subject: RE: Dupuytrens Contracture
From: Deckman
Date: 15 Jun 09 - 09:01 AM

Anne Croucher ... this is a little bit of a thread creep, but maybe NOT too much. I mentioned my Finnish heritage and the heavy diet of Rye flours, rich milk (Viilii), etc. Two of my aunts, my uncle and my father all had goiters. I was diagnosed, when I was twelve, as having the beginnings of a goiter. The remedy, successful by the way, in the late fourties and early fifty was IODINE. For many years, until "iodized salt" became available, every day I would drink a teaspoon of iodine with a glass of water. Weird eh ...! Bob(deckman)Nelson

Subject: RE: Dupuytrens Contracture
From: Mr Red
Date: 15 Jun 09 - 09:47 AM

Not much help and not necessarilly from the same cause, but that is about the same as Dango Rheinhart had. Best of luck.

Subject: RE: Dupuytrens Contracture
From: Rumncoke
Date: 15 Jun 09 - 09:49 AM

I don't use salt, but I take kelp tablets every day - except just now when I have to go and buy another tub, but usually - and I have to avoid grain, all carbohydrates really, but grains in particular as I find it is why I put on weight so easily.

When I cut out grain my digestion improved, my joints got better, and my waist measurement reduced 12 inches in a few months. My dietician had three fits as she regards grain as an important part of the Human diet - even though it never existed until about five thousand years ago, less than an eye blink in Human evolution.

I do wonder if there could be a diet element in Dupuytrens, as there does appear to be a wide range of effect, even with the genetic plus RSI elements. If you are really unlucky the finger is fully bent down, whilst others just have a strange hole in the palm and a slighly pulled tendon.

Anne Croucher

Subject: RE: Dupuytrens Contracture
From: JohnInKansas
Date: 02 Sep 09 - 11:31 PM

Probably too experimental to be of practical use now, but maybe when someone finds the thread a few years hence ...


Cure for curious claw-hand condition?

Posted on Wednesday, September 02, 2009 2:00 PM PT
By JoNel Aleccia

A disabling disease that can turn human hands into virtual claws may be eased or even cured by an injectable drug now under review by the federal Food and Drug Administration, a new study suggests. ...

[end quote - more at the link]

Articles at the link site don't usually stay up too long, but anyone interested can copy the details for future reference, perhaps.

John

Subject: RE: Dupuytrens Contracture
From: Newport Boy
Date: 18 Sep 09 - 01:27 PM

Just an update - Anne had her left hand operated on 3 weeks ago today. This dealt with the 3rd and 4th fingers - two zigzag incisions. Progress report:

Operation - 3pm. Visiting 7pm - sleepy and grumpy!

Next morning 8am - phone call 'You can collect me at 10. Don't be late!'

Home with a 'boxing glove' dressing (with tips of fingers free) and a sling. Painkiller once in the day, and not since. Able to do most domestic jobs, with restrictions. I caught her trying to slice a banana the next morning.

5 days: Checkup and physio. Small dressing to cover scars, plus a splint to hold fingers straight at night and when relaxing.

11 days: Stitches out and minimal dressing to cover one area of scar. Full movement of fingers with some stiffness. All normal activities, except as below.

18 days: Driving and cycling

20 days: Physio and revision of splint.

21 days: Swimming for the first time. Effectively back to normal, but using a protective mitt when necessary.

Hope the summary encourages others that it's worthwhile.

Phil

Subject: RE: Dupuytrens Contracture
From: Desert Dancer
Date: 16 Mar 10 - 12:34 AM

In the NY Times, an article today about a new drug (or new application of a drug) that seems to work: click.

"The Food and Drug Administration approved the drug, known as Xiaflex, last month as a nonsurgical treatment for Dupuytren's contracture, a condition in which one or more fingers cannot be straightened."

~ Becky in Tucson

Subject: RE: Dupuytrens Contracture
From: Desert Dancer
Date: 16 Mar 10 - 12:36 AM

Looks like this is the one John in Kansas posted about last fall.

~ B in T

Subject: RE: Dupuytrens Contracture
From: greg stephens
Date: 12 May 10 - 07:43 AM

WEll, I'm in for surgery on Friday. I'm a guitarist, and make my living(sparse) that way, so I've had to make an informed guess about how long to leave for recovery before the next gig. I've gambled on a fortnight: to be exact I'll have a gig in 15 days and another the day after that. I'll report back on this. The information contained in this thread has been very interesting, and very gratifying to read of fairly normal hand use after 11 days in one case. Hope I'm down at that end of the spectrum too!

Subject: RE: Dupuytrens Contracture
From: Mr Red
Date: 12 May 10 - 07:54 AM

Pun intended but there is a serious message.

Don't grasp at straws.

Subject: RE: Dupuytrens Contracture
From: Deckman
Date: 12 May 10 - 07:55 AM

Good luck on your surgery Greg. I'll be watching for your recovery reports. I also have this, and of course it gets worse each day. And yes, I also play guitar. Bob(deckman)Nelson

Subject: RE: Dupuytrens Contracture
From: Will Fly
Date: 12 May 10 - 08:05 AM

Greg - I hope the surgery goes well with you. Let us all know how you fare. Very best wishes.

Subject: RE: Dupuytrens Contracture
From: John Routledge
Date: 12 May 10 - 11:08 AM

Good luck for your op Greg.

Had my right hand little finger done in 1962 so that it did not interfere with my handwriting etc. Still works better than my left hand so well worth it :0) Can't remember a long recovery time so can't have been months.

Subject: RE: Dupuytrens Contracture
From: Deckman
Date: 12 May 10 - 11:27 AM

The connection with Nordic heritage is well documented. bob(deckman)nelson

Subject: RE: Dupuytrens Contracture
From: Newport Boy
Date: 12 May 10 - 12:17 PM

Good luck, Greg. If all goes well, the main restriction in the early days is the wound healing and removal of stitches. Guitar should be OK after that, but treat it gently for a few weeks after.

Phil

Subject: RE: Dupuytrens Contracture
From: greg stephens
Date: 15 May 10 - 06:56 AM

Operation yesterday went well. This morning I fumbled throughh G C and D7, not very smoothly, but I have got a whacking great dressing and bandage on.I also tried to play Nuages (guitarists will spot the symbolism of that!)

Subject: RE: Dupuytrens Contracture
From: Mr Red
Date: 15 May 10 - 07:12 AM

Good Luck Greg - if all else fails there is always Bodhran & Tfer.

Only joking pal.

Subject: RE: Dupuytrens Contracture
From: greg stephens
Date: 15 May 10 - 07:14 AM

I've got a mouth organ, and have my eye on a trumpet. I will in no circumstances be reduced to getting a bodhran. I am a musician, and play musical instruments.

Subject: RE: Dupuytrens Contracture
From: Tattie Bogle
Date: 17 May 10 - 08:39 PM

You need a flat left hand for a bodhran anyway (if you are a right-handed player, or vice-versa if left handed). The unmusical bodhran whackers are those who have not realised at all that using the left hand turns it into a musical intrument!

Subject: RE: Dupuytrens Contracture
From: GUEST,Mr Red
Date: 18 May 10 - 04:19 AM

Some Bodhrahnistas even use the the "flat" hand to add more percusion &/or control the snare. Ooops! Giving away trade secrets.

AND Martin Brinsford (Brass Monkey et al) plays mouth organ and Bodhran at the same time. And he is the best Ceilidh drummer I know, anyway. And I dance to quite a few.

Keep us posted Greg - but Cajun trumpet I have to see!

Subject: RE: Dupuytrens Contracture
From: Tattie Bogle
Date: 21 May 10 - 04:08 PM

I have some nodules in the palm of my left hand, which appeared after i went to a drumming workshop and hit the rim of the djembe too hard and too often with the palm of that hand. So far, after nearly 2 years, no sign of any pulling in of my fingers tho' my GP says I have early "classic Dupuytren's", and my mother had it too. No sign of any problem in my right hand so far. So I did a little research on it: radiotherapy was mentioned for very early cases, (and by ANA above) but only seems to be used in Germany, and not in the UK, whee they are hung up on "evidence-based medicine" and don't believe it works. There is a surgeon in Derbyshire who is doing a needle aponeurotomy operation, which is less invasive than the traditional Z-plasty, and takes both NHS and private referrals, but you have to have some flexor deformity already to qualify for this, See:
http://www.dupuytrens.co.uk/?gclid=CNmDuZCD5KECFQE8lAodpE3fKQ