Is it possible for thumb surgery to trigger Dupuytrens contracture?

Is it possible to have a surgery trigger this disease? Just curious. I only have it in one hand and it started a few weeks after CMC thumb surgery. I did have a cast too tight a few times the first weeks. I had NO symptoms before. I am only 53 and female. Not from Europe either. I want to do all I can do to stop this but am just baffled why it came on right after surgery. Does that mean it may not spread to other hand? You programs sound awesome. Thanks

Greetings,

My study of the literature, but more importantly my personal one-on-one discussions with men and women who have Dupuytren’s contracture, shows some frequency of stories similar to what you report.   Shortly after carpal tunnel surgery developing Dupuytren’s contracture.  Shortly after most any type of hand or upper extremity surgery developing Dupuytren’s contracture.  Shortly after moderate to severe hand or upper extremity trauma developing Dupuytren’s contracture.   A study reports that 40% of people who sustain a Colles’ wrist fracture will develop Dupuytrens contracture within three years.   The association of DC developing after even more indirect trauma with some people reporting after moderate to severe lower extremity surgery or trauma.

The typical explanation for this causation of Dupuytren’s contracture is the cascade of tissue hormones and inflammation response in the form of mast cells, lymphocytes and substance P, that develop after any injury (and surgery can easily be seen as a type of local tissue injury), triggering a local response in the hand.

Additionally, besides being concerned about what caused your Dupuytrens contracture you should also be concerned about what you can do to help your body eliminate this foreign tissue from your hand.  If I can help you or answer your questions  in that regard please let me know.   TRH

Comments

4 Responses to “Is it possible for thumb surgery to trigger Dupuytrens contracture?”
  1. Dear Dr Herazy

    I would greatly appreciate your input into helping me with my Dupuytren’s Contracture.

    In August 2013 I was diagnosed with a Botonniere’s deformity a result of a dislocated pinkie. I have been in intensive physiotherapy lasting about 4,5 hours per day since then. In April 2014 I had surgery on the pinkie. In October 2014 I discovered one lump in the palm of my left hand and was diagnosed with early Dupuytren’s Contracture (I am 47 years old and female). Additionally I suffer from chronic fatigue and have various food intolerences (wheat, peanut butter, beetroot, celery and a sensitivity to anything chemical). I also have early onset menopause as a result of the chronic fatigue and osteo arthritis in my back. I had an acute gout attack after the December overindulgences and have a few lumps in my left foot where the uric acid appears to have deposited. I am taking Dr Auer’s Base Powder to stabilize the PH balance in my body. Apart from that I have normal glucose levels, blood pressure, cholesterol levels, am a non-smoker, drinks moderately and weighs 68 kg. No other members of my family that I am aware of has Dupuytren’s Contracture.

    I currently still have full function in the hand and am able to flatten it. I have done a moderate amount of manual work with the hand since my dominant hand is my right hand. (house work and gardening). I have never played any musical instruments and have not received any treatment for the lump in my hand.

    I have a few questions:

    1. With the intensive physiotherapy is there a risk of excellerating the development of the Dupuytren’s Contracture and would you advise me to reduce the time spent on excercising (currently 1/2 hr with therapy clay 5 x per day and 2 hours of clamping the pinkie to stretch the shortened tendon). Currently, my hand specialist and therapist are both of the opinion that the exercise will not contribute negatively to the development of the Dupuytren’s Contracture.

    2. Are you aware of a link between gluten intolerance and Dupuytren’s Contracture? If so, what is your advice, if any, in this regard and on diet in general? I would like to change my diet to completely removing gluten from it and cut out all sugar except for a treat or two over the weekends. I do believe that the solution must lie in the food that we eat and currently am on about a 80% organic diet.

    3. Which of your natural treatment plans would you recommend with my health history as above?

    Thank you very much.

    Regards

  2. Dr.Herazy says:

    Greetings Marinda,

    Many cases of Dupuytren’s contracture start after a significant hand injury.

    I cannot advise you about any of the hand exercises you are doing or those done to you, since I do not know how any of them are being done. Generally, I can say that an overly aggressive exercise or 0ver-stretching of the hand for Dupuytren’s contracture can be harmful.

    I am not aware of a specific link between Dupuytren’s contracture and gluten intolerance. However, given the wide and pervasive damage that can be done by gluten intake in sensitive individuals, I would certainly do a few months of a gluten elimination diet to determine if it might improve my health in general and hand in particular. TRH

  3. Melissa says:

    I am concerned I might have early Dupuytren’s contracture. I had CMC arthroplasty surgery with a wrist tendon transfer to my right thumb in January 2016 and then the same surgery on my left in April 2016 for painful/severe arthritis with bone spurs/chips to the basal thumb joints. I recently noticed nodules in the palms of both hands and believe they are Dupuytren’s contracture nodules. I am a 47 year old female and 1/4 Swedish, but could these nodules be brought on by the recent hand surgeries I had and/or by my predisposition?

  4. Dr.Herazy says:

    Greetings Melissa,

    Dupuytren’s contracture can be triggered, in ways that are currently not understood, in genetically predisposed people when they receive a significant trauma; you no doubt agree that even skillful and delicate surgery is a traumatic experience. In some cases the trauma does not even have to be to the hand for Dupuytren’s contracture to suddenly develop; trauma can be far removed like to the head or foot. Other factors that can make a person susceptible to Dupuytren’s contracture are liver disease, lung disease, diabetes, history of prolonged hand stress (playing musical instruments and certain occupations in which wrist and forearm muscular tension is common) and the use of several prescription drugs. The more predisposing factors a person holds, the easier it is to develop Dupuytren’s contracture.

    Further, there is no way for anyone to know if or to what degree someone’s ancestry contributes to Dupuytren’s contracture, as opposed to the hand surgery, or any other DC contributing factors might be present, since so often ancestry, trauma, etc. are absent yet the person has Dupuytren’s contracture. Causation is simply conjecture.

    My first advice is first to determine by formal medial diagnosis if you have Dupuytren’s contracture. It is pointless to worry about something if it is not a reality. If it happens that you are correct then you must decide how you wish to proceed.

    At your young age it would be prudent to do as much as you can to avoid Dupuytren’s contracture surgery as long as practical, and totally if possible. Since hand surgery might have initiated your Dupuytren’s contracture response you might want to carefully evaluate the consequences to you of engaging in more hand surgery.

    All DC surgery eventually results in the recurrence of Dupuytren’s contracture. Surgery does not correct Dupuytren’s contracture, it merely gives a reprieve of a few years after which it will come back faster than the first occurrence. My experience says that for the average person I have dealt with, that post-surgical recurrence will happen in 2-8 years for 50% of people. Some people (5-15%) have fast Dupuytren’s contracture recurrence (in about 12-18 months), while other people (5-15%) have slow DC recurrence (10-12 years). The younger a person begins having Dupuytren’s contracture surgery, the more time they have to encounter this cycle, hence delay or avoidance if possible is a reasonable strategy. The recent advent of Xiaflex injections have not avoided DC recurrence since the procedure can be widely destructive to hand tissue and very traumatic in nature with the breaking of the Dupuytren’s cords; Xiaflex reports indicate it produces recurrence faster than traditional hand surgery.

    I suggest you be as conservative as possible. Consider reading a bit about the Alt Med treatment options for Dupuytren’s contracture on the DCI website. If you have any questions, please ask. TRH

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