Spire Murrayfield Hospital, Wirral, is pleased to announce the launch of its Dupuytren’s clinic. This clinic has been specifically set up for the specialised treatment of Dupuytren’s and will be lead jointly by our three hand surgeons: Mr Vijaya Bhalaik, Mr John Casaletto and Mr Alfred Morris.
Clinic specifically set up for the specialised treatment of Dupuytren’s disease
What is Dupuytren's?
Dupuytren's disease (or condition) is a very common condition and usually affects the hand, however, it can affect other body areas like the sole of the foot. When Dupuytren's disease develops in the hand, the gristle under the skin on the palm of the hand becomes thickened and contracts pulling the fingers into a rolled-up position. With the finger(s) stuck in a bent position the function of the hand is compromised.
What causes it?
Factors like excessive alcohol, smoking, diabetes and epilepsy predispose to the development of the disease. In the vast majority of patients we do not know why they develop the disease, but is probably inherited to some extent.
The ring finger is most commonly affected followed by the small, middle, thumb and index finger.
When to seek treatment?
Treatment should be sought when there is inability to lay the palm flat on a surface. However, painful nodules and disabling contractions of the fingers should be considered. Fixed contracture of the second knuckle joint of any finger should be treated as this finger joint stiffens up very quickly and surgical correction can be difficult if it is a long standing problem.
How is it treated?
Surgical treatment involves excision of the thickened cords and lengthening of the skin. It is normally done under a general anaesthetic. Non operative treatment is largely unsuccessful, although splintage is a very important adjunct after surgery.
Innovations in the treatment of Dupuytren’s
More recently it has become possible to treat Dupuytren's without surgery by injecting an enzyme into the thickened cords. This is followed by careful manipulation and stretching of the finger under local anaesthetic. The enzyme is Collagenase Clostridium Histolyticum. This non-surgical treatment is new in the UK and is set to revolutionize the way Dupuytren's has been treated so far.
How will the treatment be given?
When you attend the clinic you will be assessed by one of our three surgeons. If your hand condition is appropriate for this type of treatment you will be offered the new enzyme injection. In some cases surgery will still be required.
The injection will be administered by one of our consultant orthopaedic surgeons who are specially trained. Once the injection is administered you will be allowed to go home. You will be requested to return to clinic the following day by which time the injection will have broken down the collagen in the cord of your finger.
A local anaesthetic will be administered enabling manipulation of the finger to take place. Once your finger has been straightened you will be seen by a hand therapist who will fashion a bespoke splint for you to hold the finger in the straightened position until healing is completed. The injection is relatively pain free, but you may find it necessary to take some pain relief.