By removing the tight cords and fascia, When Dupuytren's contracture pulls the fingers into the palm of the hand, the skin can also tighten and contract. Palmar plate adhesions and collateral ligament tightness may both be causes of MP joint extension contracture. Many cases of Dupuytren's contracture progress to the point where surgery is needed. The excess collagen formation causes firm collections, called nodules, and string-like collections called cords. As a patient develops cords or flexion contractures, other options for treatment, including injections and surgery, can be an option. In addition to contracture resolution, digital edema resolves and inflamed joints become quiescent. Digital serial casting is nearly always my first choice for treatment of stubborn PIP joint flexion contractures. Judy Colditz, OT/L, CHT, FAOTA . Treating a flexion contracture requires finding out why the patient has the condition and providing appropriate interventions. In some severe cases, especially if surgery has failed to correct the problem, surgeons remove all the tissue likely to be affected by Dupuytren's contracture, including the attached skin. A Patient's Guide to Dupuytren s Contracture Surgery Compliments of: Rationale What is the goal of surgery? Dupuytren contracture is a condition in which thickening and shortening of the connective tissue occurs in the palm of the hand, that resemble cords and nodules, in which there is some finger flexion as a result. If the collateral ligaments are contracted, finger abduction–adduction in extension (normally about 45°) is greatly reduced. In these cases a skin graft is needed to cover the open wound. Methods. Volar plate. The goal of surgery is to remove the diseased fascia, allowing the finger to straighten out again. In this prospective study, subjects treated for finger flexion contracture due to Dupuytren’s disease, at the Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden between September 2009 and February 2011, were identified by searching the administrative records for the diagnosis code Dupuytren’s contracture (ICD 10 code M72.0). Find out all you need to know about contracture deformities. Surgery for the main knuckle of the finger (at the base of the finger) has better long-term results than when the joint in the middle of the finger is affected. Physical therapy to mobilize and loosen soft tissue is one option. Dupuytren's contracture is the curling of the fingers that occurs as a result of Dupuytren's disease, a problem with unregulated collagen formation in the palm of the hand and fingers. In addition, the skin becomes much less supple and flexible. A contracture deformity is the result of stiffness in the connective tissues of your body. HOW LONG SHOULD I SERIAL CAST A FINGER? This surgery is the most invasive option and has the longest recovery time. Trigger finger is not the same as Dupuytren’s contracture; they are only similar in that both involve finger flexion. 1 They may be distinguished from each other. Flexion is prevented by volar plate adhesions to the palmar surface of the proximal bony head. In the worst case, amputation of the finger may be needed if the contracture restricts the nerves or blood supply to the finger. When a release of the Dupuytren's cord is performed, the skin may need to be released or it may tear.