Treatment of Dupuytren's Contracture in Israel

Dr. Esther Lipsker

Head of the Hand Surgery Department

“Dupuytren's contracture” is a very common hand condition characterized by thickening and shortening of areas of subcutaneous connective tissue in the palm (palmar fascia). As a result, the hand and fingers become fixed in a curled position, making it impossible to straighten the fingers.

Typically, “Dupuytren's contracture” appears in the area of the ring finger and little finger, and it most often affects men over the age of 40, particularly those from Eastern Europe and northern countries: Scandinavians, Scots, and Irish. Often, “Dupuytren's contracture” develops simultaneously in both hands. The condition progresses slowly, starting with a nodule in the area of the ring finger or little finger, which may remain unchanged for months or even years. The disease can be genetically transmitted.

95%

of patients received necessary treatment

96%

of patients underwent a modern diagnostic program

1265

patients successfully completed treatment Get examined at the clinic

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“Dupuytren's Contracture”: Advantages of Treatment at Top Ichilov Clinic

Orthopedic surgeons and specialists at the Hand Surgery Center of Top Ichilov Clinic have extensive experience in performing surgeries to remove “Dupuytren's contracture.” The meticulous work of the best surgeons in Israel annually restores hand mobility to thousands of patients from all over the world.

In the early stages of “Dupuytren's contracture,” doctors at Top Ichilov Clinic often use:

1. Physical therapy
2. Thermal procedures (paraffin)
3. Exercises and honey massage aimed at stretching the palmar fascia
4. Splint bandages during sleep to keep the fingers in an extended position
5. Ultrasound treatment
6. Electrophoresis (introduction of a special drug based on papaya latex extract through intact skin using direct current). The drug is used to treat herniated intervertebral discs and osteochondrosis.
7. Therapeutic blockade (if there are painful phenomena in the area of the nodule): glucocorticoid hormones, which are strong anti-inflammatory agents, are injected into the area of the nodule. The effect of such a blockade can last for 6-8 weeks.

All these procedures can significantly improve the condition of the hand. However, in most patients, “Dupuytren's contracture” progresses, ultimately necessitating surgical intervention.

Surgical intervention is used only when hand function is impaired.

1. Open surgery involves removing the thickening, after which, if a small area is removed, the wound is left open and bandages are changed daily, or, if a large amount of skin is removed, skin grafts are taken from other parts of the body. The operation is performed under general anesthesia and lasts about an hour. To keep the hand in an extended position, it is placed in a cast, stitches are removed after 7-10 days, and the cast is replaced with a splint that the patient will wear for several months while undergoing physical therapy.
2. Needle Aponeurotomy (NA) is a minimally invasive technique used in the early stages of the disease, where no incisions are made on the skin. Instead, a special needle is inserted under the skin in several places in the palm. This operation lasts from a few minutes to half an hour, and full rehabilitation after it takes only a few days.
3. In cases of severe contracture, a joint fixation surgery (arthrodesis) may be performed.
4. In very severe cases, where the excessive connective tissue compresses blood vessels and nerves, amputation of the finger may be necessary.