The excess collagen formation causes firm collections, called nodules, and string-like collections called cords.
This is what healthcare providers call “watchful waiting.”
With collagenase injections and needle aponeurotomy, repeat treatment is not as much of a concern.
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Therefore, early treatment when the condition is less severe is becoming popular.
Thedownsideis that these nodules typically return over time to their pre-injection size, so this treatment is rarely performed.
In addition, there are possibleside-effects of cortisone shotsthat may cause problems for some people.
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Stretching and splinting were used more commonly in the past.
The problem is that these treatments seem to bemore likely to worsen the conditionrather than help it.
Stretching and splinting are sometimes used after treatment to increase joint mobility and prevent recurrence of the contracture.
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But, this is really only effective as a post-surgical or post-release treatment.
At that time, stretching and splinting may commonly be recommended.
Stretching as a treatment used on its own is generally not helpful.
John Mahoney, M.D.
Collagenase Injections
Collagenase is an enzyme that is extracted from a bacteria.
At that point, your healthcare provider will manipulate the finger forcefully to fully break the contracted tissue.
Needle Aponeurotomy
John Mahoney, M.D.
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The proponents of this procedure tout several benefits:
There are possible downsides to needle aponeurotomy.
Not everyone has a bang out of Dupuytren’s that will be effectively treated with the needle procedure.
Furthermore, recurrence of the condition can be common.
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Surgery
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Surgery has long been the most common form of treatment for Dupuytren’s contracture.
There are many variations to how surgery can be done and how extensive it needs to be.
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Therefore, recurrence of the contracture is always a possibility, no matter what treatment is performed.
The major downside of surgery is that the recovery from the procedure can involve discomfort and can be prolonged.
People may have bandages on for weeks and splints for months.
There is often physical therapy involved in the treatment.
Compared to the collagenase or needle procedure, the recovery from surgery is much more involved.
The trade-off is that your surgeon may be able to address more surgically than through those less invasive options.
Dupuytren’s disease is the condition that causes the collagen in your body to be poorly regulated.
People with this condition make too much collagen and don’t break down old collagen very well.
The treatments described here are all a treatment of thesymptomof this problemthey don’t address the underlying condition.
However, until that time, we are stuck with treatments for the symptoms of Dupuytren’s disease only.
For that reason, Dupuytren’s can, and almost always will, eventually come back.
In those cases, further treatment can be considered.
Repeat surgery can be tricky and definitely not as straightforward as initial surgery for Dupuytren’s.
In fact, some studies have shown a complication rate up to 10 times higher in revision surgery situations.
In these situations, a salvage procedure may be necessary.
However, there are possible steps to take in these difficult circumstances.
The risk of radiation-induced cancer is thought to be low.
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