I’m 59 and still active with my hands and my fingers.  My fingers have not yet started to pull in yet as it did with my father and grandfather as they got older.

My neighbor had the operation and had complications and almost lost a finger because of the Dupuytren surgery.  That is why I’m looking for other alternatives.  Thank you.

Greetings,

When these lumps appear on the palm of the hand and later develop cords that bend the fingers down, it is called Dupuytren’s contracture.  When a similar process of lumps developing on the bottom of the feet, it is called Ledderhose disease.   About 5-10% of people who have Dupuytren’s contracture will also have Ledderhose disease. 

Complications from hand surgery for Dupuytren’s contracture are far more common than what you will see mentioned when the doctors write articles on the Internet.  DCI is not against Dupuytrens surgery, but advises that a person tries alternatives to see if the palm lumps can first be reduced or eliminated so that their is no need for surgery.   There is a lot of information to help you find alternative treatment ideas on the DCI website; you can find help at Start Dupuytren treatment.

I am a 46 yr old white female who has had this hand problem for @10 yrs . My left hand (palm) has a large bump then right underneath that a section of straight bone-like section, about 2 yrs ago I developed a knuckle pad which is the same finger extending to the palm area. This pad can be moved but is painful at times very and swells larger some days.  My grandfather (on my moms side ) had dupys and my dad has dupys.  I went to an orthopedic  surgeon about the knuckle because of the pain and he said it was a ganglion cyst and wanted to drain it, now that I’ve read this I don’t believe that diagnosis.  This cause me pain the palm does not.  I am a Medical technologist for over 20 yrs doing a lot of repetitive hand movements which are now becoming more difficult, what do you suggest? 

Thank you,

Martha Burke

Greetings Martha,

It is certainly possible for someone with a family history of Dupuytren’s contracture to develop a hand cyst of some type.  As you describe your palm lump problem you do not create a clear impression that you have Dupuytrens contracture.  You do not mention inability to extend your involved finger, and you do mention the variable size of the swelling on your palm that changes from day to day; these factors are not like DC.

Since your orthopedist already gave you a diagnosis of a ganglion cyst, and you do not agree with that diagnosis, I suggest you do to someone you have respect for and ask for an examination and diagnosis.  This way you will have no doubt what you are dealing with.  TRH

Greetings,

I suppose the rarity of Dupuytren contracture would be judged differently in different parts of the world.   In several countries it might be considered rather common, while in other parts of the world it would be rather rare.

Dupuytren’s contracture is listed as a rare disease by the Office of Rare Diseases (ORD) of the National Institute of Health  (NIH) because they estimate that this problem affects less than 200,000 people in the US population.  However, some studies show that Dupuytren contracture  is common in the United States, with a prevalence of 4.4%, due primarily from current citizens whose ancestors immigrated heavily from Northern Europe. A cross-sectional study looking at the prevalence of Dupuytren contracture in 5000 patients admitted to a New York City hospital for unrelated conditions showed a rate of 4.8%, with a male-to-female ratio of 3:1.

In Northern Europe prevalence of Dupuytren contracture is much higher, ranging from 4% to 39%.  Dupuytren disease amongst the British population is found to be 34.4 per 100,000 for men aged 40-84 years, and in Norwegian populations, 30% of males older than age 60 years are said to be affected.   In men older than age 60 years, a 28% prevalence was reported in Australia, and a 19% prevalence was reported in Spain.  The basis of most of these countries occurrence of Dupuytren contracture is early Northern European migration. 

Scotland claims the highest frequency of Dupuytren contracture by which in examination of 200 patients,  39% of men and 21% of women older than age 60 years demonstrated one or more hands affected with contracture.   By contrast, in Japan, 19.7% of men and 9% of women older than age 60 years displayed hand contracture.  Only sporadic cases of Dupuytren contracture are found in the African and Asian population.   TRH

Your input would be appreciated.

Greetings,

Sorry to hear of the complication from Xiaflex hand surgery.   Your situation of the palm skin splitting open is not uncommon; it happens with some frequency although doctors tend not to discuss or warn patients about this complication.  I suspect this information is kept from patients so they will not refuse Xiaflex hand surgery.  

We both know I am not involved in the treatment of your hand and have no direct knowledge of your past or current condition.  I only know the very limited things about your Dupuytren surgery with Xiaflex injections you mentioned here.   Because of this limited information I can only ask questions:

1.   Was the doctor who did your Xiaflex injections aware you had prior hand surgery 40 years ago,  before he injected you with Xiaflex?

2.  Did you deliberately or intentionally hide this information about your previous hand surgery from the doctor, or did the doctor not ask you about the past hand surgery?  In other words, was the doctor aware of your hand surgery 40 years previously, or not, before the Xiaflex injection series was done?

3.   Since I assume you either told this doctor about the prior hand surgery, or hand scars were visible and there was no need to tell the doctor, did the doctor warn you ahead of time that this complication or adverse reaction might occur?  Was this possible complication mentioned to you, explained in detail, and were you allowed to give informed consent to refuse or accept hand surgery with this information from the doctor?   In other words,  did the doctor talk to you in detail about the potential for this kind of problem to occur so that you knew what you were getting into and had the chance to accept or refuse hand surgery?

4.   Did the doctor explain to you what there is about your hand that caused the Xiaflex to leak out from the Dupuytren cord and migrate up to the skin of the palm, causing the skin to deteriorate and burst open?

5.   If the doctor knew, or should have known, about the potential problem of injecting your hand with Xiaflex since you had prior hand surgery, what did that doctor do differently while injecting your hand with Xiaflex to prevent this complication in your case?  

6.  Did the doctor who made the Xiaflex injection that resulted in your palm splitting open, explain to you how a surgery that was done 40 years ago was able to interfere with the Xiaflex injection procedure?  In other words, if your hand tissue was stable for 40 years, what was the underlying problem that caused the Xiaflex injection to go so terribly wrong?

7.  What is the possibility the doctor who provided your Xiaflex injections simply made a mistake – as is common and easy to do during this Xiaflex injection procedure – to cause this  tissue injury and subsequent spitting to occur?  What is the possibility the doctor who provided your Xiaflex injections is simply trying to protect himself/herself from possible litigation by blaming someone or something else for this problem?

There are many cases in which these problems arise after Xiaflex injections or other types of hand surgery.  They are usually played down because this information is not good for the Xiaflex manufacturer or the doctors who do the work in the office.   I think if patients knew of the high rate of these problems – and worse– occurring, they would far less willing to allow this procedure to be done.  In my opinion it is best to avoid Xiaflex injections if at all possible by using the Alternative Medicine procedures discussed on this website.   The body can possibly reverse the Dupuytren tissue when given the opportunity. You will only know if you try.

I suggest you do all you can to increase your ability to heal and repair the skin of your palm.  Your medical doctor will not know much about this topic.  He will not explain that he has never studied or considered this topic, he will only say it cannot be done.   I suggest you contact someone who is experienced and trained in health management like a naturopath or a medical doctor who specializes in natural medicine.   TRH

Greetings,

The great majority of therapies DCI recommends that are used together in a Dupuytren treatment plan have been researched with some degree of positive or favorable outcome.  This is not true of cold laser therapy; it has never been researched directly for treatment of Dupuytren contracture.

In the past I have considered conducting a private research program with volunteer members from DCI to test the efficacy of non-penetrating or cold laser therapy on palm lumps and cords, but have refrained due to cost and logistical issues.    If you are interested in participating in such as study please contact me personally and I will investigate this issue for your benefit.    I would be interested to look into such a laser project since I  have had often thought it might hold promise.   TRH

The hand nodules are due to the Dupuytren’s contracture and the foot nodules are due to the Ledderhose disease.  I have worked with many people whose feet problems were reduced as a result of following the DCI treatment strategy.  Many had complete reduction of pain and increased mobility and loss of nodules in the feet while primarily addressing the hand issues.

You would not have foot tension if you did a few things to reduce the density and nodule formation on the bottom of your feet, so your question might not be relevant once you start treatment to assist the process of recovery from your Dupuytren and Ledderhose problems.

If you are concerned about immediate orthopedic support for your feet problem I suggest going to a podiatrist to have an evaluation made of your current situation so that perhaps foot supports (orthotics) can be made for you.  Since these usually cost around $400 or so, you might want to simply start treatment to see how rapidly your feet might improve.   The problem with getting orthotic foot supports made before your start DCI treatment, is that once your feet change – as we hope they do – they will be of little value to you and might delay your recovery by keeping your feet held in the posture they currently present.  

Good luck with your decision about how you will proceed.  TRH    

I am researching the therapies you are recommending. Since I am allergic to Sulfa drugs I probably do not want to use DMSO. Assuming I can tolerate the topical E and the CP Serum is there another carrier oil or gel that I could use instead of the DMSO? Maybe Jojoba oil or olive oil?

Thank you

Diane B

Greetings Diane,

Although it is not as good as DMSO for the purpose of driving the topical E and Super CP Serum copper peptides into the Dupuytren palm nodule and cord tissue, you can use Emu oil for this purpose.    The emu is a bird from New Zealand and Australia.  Oil from this bird has some tissue penetrating properties and can be used also.   TRH

Greetings,

Yes and no.

Yes, there is some evidence that suggest a statistical association between liver disease such as hepatitis and Dupuytren’s contracture, which as you know is associated with palm lumps and bumps.  But, not all people who have liver disease develop Dupuytrens, and not all people with Dupuytrens have liver disease, but some studies show a tendency for those with Dupuytrens to have a higher than average occurrence of liver problems for reasons that have not been clearly defined. 

No, hepatitis C dos not cause palm lumps.   TRH     

I had one Xiaflex injection for my hand on a Wednesday, and had most of the normal reactions. Swelling in hand began to subside on following Monday. I had a large bruise about 2″ wide inside same arm that went from elbow to shoulder-very dark purple, then yellow, now gone (about 1 week total). My wrist on same side also showed bruise about 3″ square area.

Worst of all, I had an extreme back issue in an area where I have degenerative disc disease (L-4). I have lived with back episodes since age 15, now age 64. I have never experienced this extreme back pain, was taken to hospital via ambulance, when pain became so strong I could not move. I did help pick up a piece of steel on Monday, nothing unusual or extreme, then I had usual sore back until Wednesday AM, when I awoke and could barely get out of bed. I had to go to the floor, then work my way onto my feet.  I could not turn, lean forward or backward or twist, lift anything.  Tried ice pack, double dose Tylenol 3 with codeine, and Biofreeze. Finally became totally immobilized due to intense pain, called 911, went to ER, several muscle relievers and pain shots, came home and am taking medication now. In my adult life, I have never experienced anything near this intense. I wonder if the Xiaflex softened/weakened the tissue between the disc in my back enough to cause this problem.

I would like to hear if other chronic back patients who suffer milder problems same as I do every six months or so had an extreme reaction. Are there others with chronic bone/nerve connectivity issues who also had extreme occurring?

It seems plausible because of the reaction up my arm that the drug also could be carried into other parts of the body, weakening tissue.

Thanks.

Greetings,

I have explored this topic at some length for you.  While there is some small suggestion that Xiaflex might migrate from the primary area where it is injected, the research – at this time – says that it would be stopped at the lymph nodes.  In the case of Xiaflex treatment for a Dupuytren hand problem, this would mean it would probably go no further than the lymph nodes in the armpit. There is no current report of Xiaflex traveling throughout the body, as you suggest.

It would seem that the most likely explanation is that your extreme low back pain flareup was not much more than a coincidence.    TRH

family history of dupys, aunt, mom, and sister and myself, my sister has has several hand surgery’s, my mom has had frozen shoulder and recently her hands started swelling, me, both hands and ledderhose disease.   i am a flight attendant and it is greatly affected my work.  i can’t work much to to the pain.  i have plantar fascitis.  my hands and feet ache and throb now, and my moms hands are swelling.  we all have garrods pads as well.  i am concerned with the ledderhose disease.  the lump on my left foot gets larger when i work and is very painful, i have to take pain meds.  at the end of a flight i am miserable.  i am looking for any suggestions.  ancestry is from england and we all have blue eyes, go figure.

Greetings,

Yes, it must be wonderful to have Vikings on the family tree.

I suggest you go to the DCI website and get busy by reading a few things to educate yourself about self-care of Dupuytren contracture (which often also has a beneficial effect on the Ledderhose disease of the feet).   You might read Start Dupuytren treatment to better understand the process and a few of the links you encounter along the way.