Dupuytren contracture recurrence after hand surgery

Posted on March 23, 2023March 23, 2023 by Dr. Herazy

Recurrence of Dupuytren contracture is common

Dupuytren contracture recurrence means that the abnormal palm and finger tissue comes back after surgical removal. For example, after surgically removing the palm lump, it grows back again. And, after surgically straightening the bent finger to some degree, the finger cord grows back, pulling the finger down toward the palm again. This happens because this is the nature of Dupuytren disease. Excessive and spontaneous collagen production in the palm of the hand continues because surgery cannot stop it.

Recurrence of Dupuytren contracture after surgery is common and frequent. This return of the Dupuytren contracture tissue is exactly why some people have 2-4, or more, hand surgeries. They always think the next surgery will solve their problem.

Surgeons admit that “sometimes the Dupuytren contracture returns within a few months after surgery. Other times, it can return many years – even decades – later.” It has been written, if a person lives long enough after hand surgery, the Dupuytren tissue will eventually return.

No Dupuytren contracture recurrence with natural treatment

Good news! Based on reports from customers using the DCI large treatment plan, 8-10 people have moderate to marked reduction of palm lumps and finger cords, for every one who reports no change. Since 2002, no one has ever reported a recurrence or worsening or side effect after improving their DC with the DCI treatment method.

The purpose of using natural Alternative Medicine treatment is to get that DC tissue healing, thus avoiding the need for any hand surgery. If you can get better on your own, there is no need to worry about Dupuytren contracture recurrence.

The DCI treatment system has saved countless people from needing hand surgery. Their fingers and palms improved enough with the DCI method that they, and their doctors, did not think surgery was still necessary.

Get started with Dupuytren’s contracture natural treatment

An old and common surgical problem

The greatest French surgeon of the 19^th century was Guillaume Dupuytren. Even so, he also had patients whose palm lumps and finger contractures returned after hand surgery. He experimented with a variety of tactics and methods to minimize the return, but none were totally successful. Some things never change.

So, if Dupuytren contracture continues to be a problem during 300 years of surgery, what does that mean? That they were all bad surgeons? No, of course not. Actually, even fantastic surgeons must deal with recurrence of Dupuytren contracture. Fundamentally, the real problem is that Dupuytren disease is a nasty problem. After surgery the patient still has Dupuytren disease. And, of course, this means the patient still has the tendency to produce too much collagen and fibrin – even after surgical removal of the palm lump and finger cord.

Here is the nasty truth about Dupuytren contracture: There is no way to get rid of it by cutting it out or dissolving it with Xiaflex (collagenase enzyme). It just keeps coming back.

Hand surgery to remove the palm lump and finger cord is like hitting a skunk with a stick to get it out of your garage. Forcing the skunk out just creates more trouble, and you get more of what you are trying to get rid of.

DCI thinks it is smarter and safer to get the skunk to leave quietly, naturally, so it does not cause any more stink.

People tell us about their Dupuytren contracture recurrence

At DCI, we talk to many people about their Dupuytren problems. As you might suspect, the subject of Dupuytren contracture recurrence is a popular topic. Based on these conversations, we learn the average persons’ Dupuytren recurrence returns 2-3 years after surgery. It is not uncommon for recurrence to start in less than a year; some just a few months after hand surgery. At the other extreme, other people say their DC took 5-10 years or more to return.

In addition, we discuss the actual condition of the hand when the DC returns. Do not assume that after returning, the Dupuytren problem will be the same as before surgery. Perhaps it might feel good for a few months, or even or year or so. Eventually, the hand contracture will return. How good or bad the hand becomes depends ultimately on many different factors that are beyond the control of the doctor:

Amount of normal and abnormal superficial and deep tissue that must be removed.
Size of the palm lump and finger removed.
How deeply the palm lump and finger cord has grown into the surrounding normal tissue.
Where the palm lump and finger cord are located in relation to important blood vessels, muscles and nerves.
If skin grafts are necessary to close the incisions, and if they heal well or get infected.

What happens after hand surgery?

After hand surgery, the patient still has Dupuytren disease. Surgery only removes the thick contracted tissue; the disease remains. Therefore, the patient’s hand can still produce an excessive amount of collagen and fibrin in that same area of the hand. When it does, it is called Dupuytren contracture recurrence.

Removal of a large percent of tissue from the palm of the hand has consequences. It often results in a worse situation than before the hand surgery, for several reasons:

Continued scar formation causes the palm to become even thicker and less flexible.
Pain due to scar development after the removal of normal and abnormal tissue during surgery. It can be mild to severe, and occasional to constant.
Numbness and tingling of the fingers and hand due to that same scar development.
Permanence of some degree of finger joint stiffness. Seldom are fingers completely straightened after surgery. And over time they stay flexed even more than before.
Loss of muscle and valuable connective tissue with each surgery, causes weakness and awkwardness of finger and hand movement.

What is the possibility of recurrence

First of all, there is no way to accurately predict anything about Dupuytren recurrence after surgery. No one can say when recurrence will happen; how severe it might be; or what symptoms might develop.

However, a few statistical indicators suggest recurrence of Dupuytren contracture could happen sooner if one or more of the following is true:

Finger joint flexion fixed at 30 degrees or more.
One or more immediate family members also have DC.
One or more ancestors are from northern Europe or Scandinavia.
Younger than 60 years of age at onset of DC.
Palm lump and finger cord are developing rapidly.
History of diabetes or liver disease.

Final comment

In 1964 Weckesser stated, “In general, the longer the follow-up period [after Dupuytren’s disease surgery], the lower the percentage of good results.” This means that shortly after surgery the hand can feel and look pretty good. However, as weeks and months pass, it is very common for the hand to tighten up again. The results and benefits that looked so promising at first, fade and worsen. This return of the contracture ultimately causes more pain, numbness, weakness and other related problems.

Surgery for Dupuytren’s contracture only provides a temporary break from the contractures and other related complaints. The recurrence of Dupuytren contracture might not be too bad if the time of relief was long enough. But this is not the case.

People usually say that the short period of relief they got from hand surgery is not worth what they went through. They felt the risk of surgery, the pain, hours of rehab, cost, complications and side effects related to the surgery and subsequent complications related to Dupuytren contracture recurrence did not justify what they got out of it.

It is reasonable to first be conservative. Try a simple natural approach to help your body heal the DC tissue, and so naturally remove the Dupuytren tissue. Better to work hard to avoid needing hand surgery if possible. You can always have surgery later if it is still necessary.

Learn about Dupuytren’s natural treatment

Will this Dupuytrens treatment keep the hand lump from getting larger and my fingers from curling?

Posted on March 15, 2013April 6, 2013 by

Hello Dr. Herazy, I have a question about dupuytrens treatment. I am a 51 yr old women who was just told the small lump in my hand is dupuytren’s contracture. I was told right now there is nothing that can be done because I can still put my hand down flat on a table. My husband found your site and wants me to start the treatment. Can I start the dupuytrens treatment at this early stage of the disease?

Will this keep the lump from getting larger and my fingers from curling?

Thank you for any information you can give me. Roseann

Greetings Roseann,

Sorry to hear of your hand problem.

From my experience in working with this form of natural Dupuytrens treatment for almost 11 years I can tell you that the earlier you start self-treatment, the better the results tend to be. All we are attempting to do is to support and reinforce the natural ability of the body to remove foreign tissue; an early start when the problem is as small as possible, makes most sense.

This concept is different from the standard medical approach your doctor is suggesting, because that approach is for radical removal of tissue. The standard medical model is based on the hand contracture being as advanced, debilitating and severe as possible before surgery, so that the surgery is not done too soon in the course of the disease. All surgeons know that the surgery is not a cure, and that Dupuytrens recurrence is inevitable after each surgery, no matter how well done. By waiting to do surgery as long as possible the number of recurrences is minimized.

Our concept is that if surgery can possibly be avoided by doing everything possible to help the hand lump heal with natural Dupuytrens treatment, then a real service has been provided. There is no way for me to tell you if this approach will work for you. I can tell you it has worked for many people, especially when started early in the progression of the contracture. I suggest to you that you use the largest and most aggressive therapy approach you can afford to apply for at least 2-3 months to see if your body is capable of making this Dupuytrens treatment work for you. If it helps you, look at what you have gained. If it does not help you, you will know you have at least tried to do something conservative before undergoing aggressive hand surgery.

Please let me know if I can help you in any way. TRH

Should I wait for my Dupuytren disease to get worse and have more hand surgery?

Posted on March 20, 2012 by

In September I had an operation to remove the tendon-like Dupuytren cord from my upper palm and little finger. Developed a good bit of scar tissue as a result can’t bend the finger yet, so lots of exercises. Just yesterday I noticed nodules in my lower palm where the muscles are being used to do the exercises to get rid of the scar tissue. Went to the doctor today and he confirmed a re-occurrence of Dupuytren contracture just six months after my hand surgery. But he says there is nothing to be done until they curl the fingers. Should I be doing something else because I feel I am in early stage with the Dupuytren cord in my palm?

Thank you,

Robbie Trent

Greetings Robbie,

It is not at all uncommon for Dupuytren contracture to recur in less than a year after having hand surgery to remove the palm lumps and cords that are a part of this problem. Yours seems to have come back in six months, which is not rare; I hear a lot of these fast recurrences. I hope your hand surgeon told you all about this. Again, I hear a lot of stories from people who are not told ahead of time about how the Dupuytren contracture will always come back after surgery. These people go into surgery thinking that the hand surgery will get rid of their problem, only to find that is not the case.

Dupuytren surgery will only give a temporary relief from the problem, and sometimes the temporary relief if extremely brief, as in your case. This is very discouraging because the brief relief comes at the high price of months of surgical pain, poor healing, months of painful exercises, all ending with a hand that is not as good as before the surgery and needing more hand surgery anyway.

You need to talk to your hand surgeon about where all of this is headed. You should understand that usually the result of additional hand surgery is not a better hand, but a hand that has even more normal tissue removed resulting in risk of greater pain, limitation of movement, coldness, numbness and weakness. Additionally, you must understand that typically the speed of recurrence of Dupuytren disease after hand surgery increases with each surgery; each operation seems to make the problem come back a bit faster than the one before it.

You might want to read, Dupuytren hand surgery can be dangerous: Facts you should know and My hands got worse after Dupuytren’s surgery, what can I do?

Notice that at no point do I say that you should not have more hand surgery. I am just cautioning you that not all surgery is successful – like all Alternative Medicine care is not successful. You should ask a lot of questions and be sure of what you are getting into because all of the hand surgery sites warn about the return of Dupuytren contracture after surgery. In my opinion it is better and smarter to first use conservative self-help measures that do not carry the risks of surgery, and only use surgery after all possible conservative options have been used and have failed.

The Dupuytren Contracture Institute has been helping people for over 10 years increase their ability to heal and repair the Dupuytren tissue changes. Some people get dramatic results and some only slow down the rate of progress; every one is happy for the improvement and progress made because it is better than doing nothing but allow the problem to advance on its own. I suggest that you go to the DCI website and read a bit about how you might be able to help yourself.

Will your Dupuytren treatment also help a trigger finger problem?

Posted on March 3, 2012 by

I have both Dupuytren’s contracture and trigger fingers. Will your treatment cover both problems?

Greetings,

I do not have an answer for you. While the DCI treatment for Dupuytren’s contracture has had a lot of successful application for palm lumps and contracted fingers, I have not had much feedback from people how if affects a trigger finger. I think there are elements of the DCI treatment protocol that might help the swelling and inflammation of the tendon sheaths in the palm of your hand that causes your fingers to periodically catch, called trigger finger.

For the most part a trigger finger problem tends to be more of a nuisance to a person, but Dupuytren contracture is a much larger and more dangerous problem to the health of a hand. I suggest that you get busy doing everything you can to help your body heal your Dupuytren disease, and see if at the same time your trigger fingers improve. I think the most important consideration is to first get the Dupuytren under control and deal with the trigger fingers later – if they are still even a problem. TRH

Do you think my hand lump and pain are Dupuytren contracture?

Posted on February 23, 2012February 23, 2012 by

my doctor told me i have dupuytren contracture in my right hand. i had a small lump came in my hand after i had carpal tunnel surgery about 3 years ago. lately it has gotten worse. now doctor tell me about dupuytren disease. at the start i had very little pain, but i have pain all the time now. i play the piano and maybe that the reason i’m in pain. what do you think? my fingers are not bent, just in pain . joyce

Greetings Joyce,

It is not uncommon for Dupuytren’s contracture to start after hand surgery, like for Carpal Tunnel Syndrome. It is also not uncommon for Dupuytren’s contracture to occur in piano players who stress their hands, arms and shoulders by prolonged practice and playing. Early stages of Dupuytren disease will only demonstrate a palm lump or two with variable pain, and no finger contracture or stiffness. The problem of finger contracture appear only later when cords of soft tissue develop in the palm. Based on your brief description your problem does not seem out of the ordinary for an early case of DC.

Apparently your doctor, who has examined you, thinks you have Dupuytren contracture so I think there is no reason to doubt that diagnosis.

I suggest you consider getting busy treating your hand problem with Alternative Medicine therapy while it is still manageable. Go to start Dupuytren treatment for more information to help your body heal this problem. TRH