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 the subcutaneous connective tissue of the palm (palmar fascia). As a result, the hand and fingers become fixed in a bent position, making it impossible to straighten the fingers.

Typically, “Dupuytren's contracture” appears around 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

Notify me of prices

“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. Splinting during sleep to keep fingers in a straight position
5. Ultrasound treatment
6. Electrophoresis (introduction of a special drug based on papaya latex through intact skin using direct current). The drug is used for treating 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 nodule area. 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, so eventually, surgical intervention becomes necessary.

Surgical intervention is only applied 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 a straight 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 skin incisions are made. 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 overgrown connective tissue compresses blood vessels and nerves, amputation of the finger may be performed.