I understand, although I am not a doctor, that Dupuytren's is an illness with genetic roots - that it's a malfunction in your genese that causes the hand to produce unnecessary scar tissue. So I wouldn't say that surgery could cause Dupuytren's. However, I know that many people find the condition becomes worse - or they first notice it - in response to trauma. I had no signs of the disease until I had surgery on my right hand for trigger finger. Following the surgery, I developed nodes which are 3cm long and 1cm in diameter - I initially thought they were some sort of complication, and when I followed up with my hand surgeon, he let me know what I had. So my understanding is that, I always had this disease lurking in my genes, and I would have developed it eventually anyway, but the surgery led to more rapid development than I would have had without it.

Dupuytren's is not a tendon disease. Dupuytren's does not happen "overnight". Tendon problems can happen quickly if there is dis-rupture in the relationship between the tendon and tendon sheath.

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thanks for sharing that newman, very informative stuff
I wish all the American CHS's could view that video.

Reading some recent comments from Dr. Eaton some of that info is slowly making it's way in the USA.

Dr. Kirkpatrick: Are you aware of other new treatments under development that have potential in this area?
Dr. Eaton: At an international symposium on Dupuytren disease in Miami earlier this year, we had 47 speakers from 13 different countries with some very interesting information and some new ideas. These included the use of custom silicone rubber splints after surgery that showed progressive improvement and extension over the course of months.

A report on using an absorbable carboxy cellulose implant as a spacer at the end of a limited fasciectomy for Dupuytren showed better early term results than not using that type of spacer. A variation of a needle release technique, using multiple superficial releases of the fascia over the entire distance of the palm, was also reported.

The most groundbreaking presentation was on the use of preoperative adjuvant tamoxifen to treat patients who had high risk for recurrence after a surgery. This randomized study showed that high-risk patients who had the preoperative treatment before limited fasciectomy for Dupuytren maintained their surgical correction to within about 10 degrees. Patients who were randomized to just the surgical treatment lost an average of 40 degrees of their initial correction.

The study used oral tamoxifen, but I’m considering a trial with topical tamoxifen. The big issues with patients who have aggressive Dupuytren are the extent of skin involvement and the dense relationship between the skin and the fascia as part of the biology. A minimal approach to straighten the fingers, followed by some sort of biologic intervention to maintain those results, would be great.

Radiation has been a commonly used approach in Germany. Radiation does have a biologic effect on nodular Dupuytren but not on the cords; it’s an option for patients who have early Dupuytren with a lot of nodular involvement. The amount of radiation used in the current protocols is fairly low and the chance of side effects is low, but we have yet to see long-term results.