Tag Archives: contracture

What is my recommendation for a confusing contracture of finger?

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Hello,

A recent diagnosis of this contracture is confusing. For a couple of years I have had what was treated as a ganglion on my middle finger–it wouldn’t break. Then that finger started to bend oddly. I purchased some herbs for the cyst and it really helped the lump but it seemed to go into the fatty pad in my ring finger which started to bend. now the the doctor says that the ring finger is the contracture–with no treatment recommended but the pain is severe and all this seems to be going into the other hand.

The doctor wants to remove the remaining ganglion, etc but it seems minor compared to the pain in the ring finger. I have been doing stretching exercises, etc. but it is getting so bad I need some help (and would like to avoid even the more minor surgery). I am familiar with real pain as I have bone on bone in my ankle–from injury. The hand pain is getting close.

I feel I am in early stages and would like your recommendation for treatment.

In addition I need to know if these treatments are safe to use as a mild diabetic.

Thank you.

Mrs. Lana Long

Greetings Lana,

Thank you for your inquiry.

You did not directly state in your email whether your current diagnosis is actually for Dupuytren contracture, nor did you directly state that you had a formal diagnosis of a ganglion cyst of the middle finger.  I get the impression from what you reported and did not report that much of what you have said about your finger and hand problem is self-diagnosed, and this concerns me.

Considering there are several elements of your description that causes me also to be uncertain of your problem (such as the severe pain you describe, and initial involvement of the middle finger), and that your description makes it appear that your condition is actually worsening under your doctor’s care, my recommendation is that you get a second opinion from a hand specialist in your area to confirm your current condition and appropriateness of your current care.

When you have done this and can confidently report back what is happening in your hands I would be happy to reply to your inquiry.

TRH

Dupuytren surgery question

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Dear Dr. Herazy,

My father has been diagnosed with Dupuytren’s some months ago, but only recently has complained about any pain. The pain is not unbearable, it is just a feeling to remind him that it’s there. So nothing big at the moment.
He wants to treat it, but he has asked me to investigate on when is the best time to have the surgery? His hand is still in the early stages of the contracture. Should he have the surgery as early as possible, or is it better to wait until his fingers are contracted more?
Thank you,

Partin.

Greetings Partin,

I must commend you on being a good daughter to help her father in this way.

You must remember that this site is devoted to the non-drug and non-surgical treatment of Dupuytren contracture.   There are those cases that probably should undergo Dupuytren’s surgery, but in the opinion of DCI surgery for someone like your father should only be done after more conservative measures have failed to improve his situation.

Usually Dupuytren contracture is not painful, except during the early stages and then only for a limited time.  Many of the cases whose hand pain persists and undergo our Alternative Medicine self-care report rather rapid and complete elimination of pain.   If it is only pain relief that your father is interested in, he should not be overly concerned since this usually is self-limited after a short while.  this process of pain relief is something that responds to well with our treatment measures.

Since Dupuytrens will return after all forms of hand surgery, given on average about five years, your father should understand that Dupuytren surgery is not an absolute final treatment for anyone. Typically, after the first surgery when the problem recurs it is a little worse and returns a little sooner after each surgery that is done

An orthopedic surgeon who works with Dupuytren cases will usually decide when and how to perform surgery on the hand based on several factors:

1.  Age of the individual
2. Duration of DC
3. Severity of involvement
4. Degree of limitation of use
5. Degree of reduction of quality of life
6. Family history of DC
7. History of past injury and surgery to hand

While no specific rules exist that determine when Dupuytren surgery should be done,  many surgeons recommend when the large knuckle of the involved finger reaches 30 degrees of flexion contracture.  When the problem returns after surgery or causes more severe contractures after the surgery heals, fusion of the individual finger joints is sometimes recommended.   In the worst case, finger amputation of the finger is recommended if the developing contracture restricts the blood or nerve supply to the finger.   TRH