Dupuytren’s (pronounced də pwiːˈtræ̃z, or dəˈpwiːtrənz) contracture is a common disease which affects the fingers of the hand, especially the ring finger and little finger. It can take control of either one or both hands, causing the affected fingers to fold inwards into the palm like aclaw. The contraction can be sudden, but for the most cases it happens gradually over time and the disorder usually manifests itself in old age (after 40). It is more frequent in men than women (almost seven times more!) andwhite men more than men of color.
It is caused by the thickening and tightening of a tissue called the “fascia” that lies under the skin on the palm. The surgical treatment for this is called a Fasciectomy, where the hardened, fibrous fascia is cut off, allowing the fingers to straighten out again.
Post-surgery physiotherapy sessions are very important to achieve a speedy and complete recovery. You will be asked to attend physiotherapy sessions for 5-6 weeks; it can be more or less depending on your speed of recovery. These include heat treatments, massages, and dupuytren’s contracture exercises. The exercises arehandexercises to help regain the fingers’ flexibility.
The workout is quite simple and so you can do the exercises at home without supervision, and your therapistwill direct you to do them. It is best to do the ones recommended by them, and as often as they say, for best results.
According toMyHealth.Alberta.ca, your fingers may be swollen for a few days after the operation and you may also need pain killers for the first week or so. You might have to wear a splint for many months after the surgery, especially at night, to keep the fingers straight.
Following surgery, your daily activity should be limited and you should not exert your hand too much. If your job involves a lot of hand movement like typing, you will have to take a leave for at least a couple of weeks. This is again subjective to your speed of recovery.
You should maximize on rest for the initial few days and gradually ramp up your activity. It is good to take small walks. Donot however, exert your hand by lifting loads, typing, scrubbing, cutting food in the kitchen, holding equipment that vibrates or anything that counts as repeated hand movements and can exert undue pressure. Keep your hand dry unless allowed by the doctor to wash it.
Post-operative care ispart of the treatmentand essential to a patient’s recovery. Abide by the precautions told to you and just focus on the flexion and extension hand exercises that are instructed by the therapist and aresafe to do.
Dupuytren’s contracture exercises
Here are some simple beneficial workouts for your hand that can help you regain flexibility and control different types of movements again. It is best however to apply these in conjuncture with your physiotherapist’s instructions.
You can do these in repeats of 10, and 4 times every day.
Gently bend and straighten your fingers occasionally throughout the day to increase their flexibility and reduce the numbing and swelling.
Another bending exercise: Bend all your fingers inwards so that only the first two joints are bent in, but the knuckles are not. Maintaining this position, arch the knuckles backwards and back in again. Repeat.
Place your hands palms-down on a smooth hard surface. Spread out all your fingers as far as you can like a starfish (without causing pain) and then close them back in again. You can do this with your hand in the air too. To help, you can use two fingers of the other hand to stretch each pair of fingers apart further so that you feel a little stretch.
Practice swiping each finger separately across the surface, side to side, multiple times.
Again keep your hand palm-down on a table and then, one by one, lift each finger up and keep it there for five seconds. Put your finger back down and do the same with the next finger and so on.
Touch the tip of your thumb to the tips of all the other fingers in succession. Also practice touching the thumb to the base of your little finger.
Gripping exercises are also great to recover gripping power and control. Practice holding different objects, starting with bigger ones that require less bending of the fingers and then move to smaller ones that need more precise control.
Straighten and hold
Use two fingers of one hand to straighten the affected fingers of the other. Arch them back until you feel a little tension (not more) and keep them in that position for 10 seconds.
Another thing you can do is use your pointer finger and place it just above the knuckle of the affected finger from the palm-side and push it back till you feel tension. Then slowly move upwards, pressing the whole finger back. This will help exercise even the smaller intrinsic muscles in your hand.
Use a rounded or cylindrical surface like a thick highlighter pen, marker, or a small rolling pin, place it on a table or any flat surface, and then roll it back and forth by pressing the palm of your hand against it. You can do this for a few minutes up to as long as you like- it will give your hand a relaxing massage.
Give you hand a full massage as well, twice a day.
With all of these exercises, make sure your movements are gentle and you don’t overstretch as this can make the contracture worse instead of helping it. Avoid clenching your hand too tightly in a fist or holding objects that require a strong and closed grip.
Be consistent with your workout and make sure to visit the physiotherapist regularly alongside occupational therapy