Dupuytren’s disease
Dupuytren’s disease is a fixed flexion contracture of the hand. The disease is a slowly-progressing contracture of the palmar fascia in a process called palmar fibromatosis. The condition usually affects the little finger and ring finger. In advanced cases, the disease can also affect the long finger, but the index and thumb are almost always spared. The disease occurs primarily to those over the age of 40, and has a strong genetic preponderance to people of Scandinavian ancestry.
Treatment is to restore function to the hand, but it rarely cures the disease. The treatment may have to be repeated if the disease process is rapidly progressive. This varies between individuals. Treatments of Dupuytren’s disease include Collagenase injection, surgical limited fasciectomy, dermatofasciectomy, radiation, percutaneous needle fasciectomy, fasciectomy with grafting, and many more.
The wide variety of treatments illustrates the progressive nature of the disease and the varied attempts of physicians for two centuries to control the disease and slow its progression. Dr. Mussman uses limited fasciectomies, skin grafting, and adjacent tissue transfers when necessary to treat the disease.