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Dupuytren diagnosis following botched carpal tunnel op
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02/27/2011 09:33
tomc 
02/27/2011 09:33
tomc 
Dupuytren diagnosis following botched carpal tunnel op

Hi there,
When my wife (then aged 31) was pregnant she started to suffer from tingling / dead hand typical of carpal tunnel. Apparently this commonly starts during pregnancy. Having put up with it for seven years, last summer she decided to have the operation required to fix her carpal tunnel, which was an incision through the palm and I presume widening of the "tunnel". She kept the hand strapped up in a sling for a few weeks, but gradually it became clear that something was wrong as she was not regaining use of the hand correctly. She was unable to straighten her fingers, and did not have sufficient strength to grab. She has been seeing a physiotherapist who gave her hand stretching exercises and hot and cold water baths for the hand initially. She is now able to grip with the hand but still unable to straighten her fingers. In recent weeks though, she has developed lumps in her palm and the physiotherapist says that she has got Dupuytren's. Looking at photos on google, I have to agree, that her hand now looks exactly the same as those pictures of typical Dupuytren's. Recently she saw the surgeon who performed the carpal tunnel operation, who also diagnosed Dupuytren's and said it was just a coincidence.
However, she has no family history of Dupuytren's, and had no evidence of it prior to the operation. The other hand is fine. I have read that Dupuytren's can develop following trauma to the hand. It seems pretty clear to me that the Duypuytren's has come on due to the operation, but proving this is going to be very difficult. Are there any other recorded cases of this?
Thanks for following all this!
Tom

02/27/2011 14:21
callie 
02/27/2011 14:21
callie 
Re: Dupuytren diagnosis following botched carpal tunnel op

I don't think it is as uncommon as you might believe. I have two acquaintances who have had carpel tunnel and Dupuytren's simultaneously. I think it is a leap for you to call it a "botched carpal tunnel surgery" just because Dupuytren's is present. Dupuytren's does not just appear because of a surgery. It was always there. Yes, many feel that a stimulus can trigger growth of Dupuytren's.

You said, "However, she has no family history of Dupuytren's, and had no evidence of it prior to the operation." That would not be unusual, especially if the Dupuytren's had not yet formed the telltale signs.

You said, "It seems pretty clear to me that the Duypuytren's has come on due to the operation, but proving this is going to be very difficult." That is very possible, but that is no reason to label the surgery as "botched". There are/were two separate things going on prior to the surgery, most likely.

02/27/2011 14:55
David26

not registered

02/27/2011 14:55
David26

not registered

Re: Dupuytren diagnosis following botched carpal tunnel op

I agree with callie, the surgery could have induced the Dupuytren's to flare up but IF that was the case it would be related to the trauma (cutting of the palm/fascia tissue) and not a botched surgery.

02/27/2011 16:33
fjellver 
02/27/2011 16:33
fjellver 
Re: Dupuytren diagnosis following botched carpal tunnel op

Hi tomc,

I saw a top hand surgeon in my area a few months ago about my DD flare that occurred after some minor trauma to my ribs. He said DD often first appears after bodily trauma, it does not have to be to the hands either. He also said it does appear very commonly after hand surgery. He tries to avoid hand surgery, including Carpal Tunnel release in DD pts.
She must have the gene, you only need one, as it is an autosomal dominant gene.

Sorry about your wife's problem. First, I would consider steroid injections. There are some reports of success in decreasing DD after surgery using RT also. I would look at the RT Clinics listed on this great website.


Best,
Fjellver

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