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can hand surgery cause Duypuytrens?
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04/09/2016 16:26
jimbob0802 
04/09/2016 16:26
jimbob0802 
Re: can hand surgery cause Duypuytrens?

Okay, thanks for your input Stefan and Meunier. Yes I think the gap would suggest so, I was just curious if there has been instances of trigger finger 'oupatients' developing DD. I guess if you've got the gene, you've got the gene.

Just attached one more photo, new from today. My nodule is massive - I hope it isn't beyond treatment. Something's going to be have to done to it, as it's stretching the skin across from the rest of my hand, especially D4!

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IMG_0849.JPG IMG_0849.JPG (30x)

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07/10/2016 23:07
whatsupdrk 
07/10/2016 23:07
whatsupdrk 
Re: can hand surgery cause Duypuytrens?

Just found this site while trying to research this problem.
I'm a 60 year old male Caucasian (that seems to put me at risk).
I had trigger finger surgery on my right middle and ring fingers last November (2015). I had post-operative numbness in the ring finger for a few weeks, and pain and stiffness in those two fingers as well as at the site of surgery. I began to fear I had RSD, but the numbness resolved. The pain and stiffness never did.
Over the next few months I have slowly improved, never completely.
As of today, July 10, 2016, I still have pain in my ring finger and palm of my hand. I have developed a tender "knot" at the site of that ring finger's incision in my palm. I assumed it was just scar tissue from the surgery. My grip is not strong but I can function pretty normally. It does affect my ability to grip golf clubs or my tennis racquet.
I saw my doctor again the other day for a wrist problem (that I am convinced was at least partly caused by intense therapy and stretching of my hand over the past 6 months!) and he told me it looks like I have Dupuytren's. This kind of floored me. Never had any such problem before my surgery last fall.
All these posts are fascinating, as I see a number of you who have had trigger finger issues.
I am now wondering if I really had trigger finger at all, but maybe had Dupuytren's in early stages that was not diagnosed. I never had true "locking" of the trigger finger, just pain and stiffness for several years. He said that was the same as "Trigger Finger," just another name for tenosynovitis of the finger tendons.
After annual steroid injections for several years he told me last year we should just fix the problem with "simple" tendon release surgery. When scheduling it he said I had "mild" tendonitis in the middle finger, so we might as well fix it at the same time! Sounded reasonable at the time...Luckily that finger has no issues (yet!).
It's never been the same, though I could do my usual daily activities (with some discomfort).
Every morning I still wake up with stiffness in my right hand, can't make a fist until I've been up for 30 minutes or so.
So what does the group think? Did the original symptom cluster indicate early Dupuytren's and not trigger finger? Did the surgery and trauma to the tendon cause the Duputren's? Or was I genetically vulnerable and this just sped up the onset? Did the multiple steroid injections have anything to do with this?
And what do you all think of the treatment options?

07/11/2016 06:41
spanishbuddha 

Administrator

07/11/2016 06:41
spanishbuddha 

Administrator

Re: can hand surgery cause Duypuytrens?

Hi and welcome to the forum.

It's difficult to help with diagnosis by the Internet, even with photos, but it does seem if one is genetically disposed to getting DD then hand surgery can well be one of the triggers that sets it off. We get quite a few posts of people having DD appear after surgery for carpal tunnel, trigger finger, even tennis elbow, or some trauma to the hand or a wrist fracture.

The treatment options are described on our treatment pages. RT for early stage with no contracture when the disease is active. If you do indeed have DD that has appeared or made worse by surgery, it would seem you appear susceptible to aggravating it with (more) surgery, then seek NA or Xiaflex to relieve a contracture. Maybe it will quieten down, so you can take some time to investigate the options a bit more and find appropriate doctors. But first you need to get the diagnosis confirmed by an experience hand doctor.

SB

07/11/2016 16:39
whatsupdrk 
07/11/2016 16:39
whatsupdrk 
Re: can hand surgery cause Duypuytrens?

Thanks for the prompt reply!
I'm new to this. I'll try to go through your site, but can you tell me what RT is? What about NA? I can Google the Xiaflex option.
Of course I think I have a good doctor, but I wonder if he wants to take responsibility for possibly contributing to this condition with the surgery I had. Oh well.

I'll keep watching this site. Hopefully it won't progress...

PDK

07/11/2016 18:26
spanishbuddha 

Administrator

07/11/2016 18:26
spanishbuddha 

Administrator

Re: can hand surgery cause Duypuytrens?

whatsupdrk:
Thanks for the prompt reply!
I'm new to this. I'll try to go through your site, but can you tell me what RT is? What about NA? I can Google the Xiaflex option.
Of course I think I have a good doctor, but I wonder if he wants to take responsibility for possibly contributing to this condition with the surgery I had. Oh well.

I'll keep watching this site. Hopefully it won't progress...

PDK
Sorry about the acronyms RT is Radiotherapy http://www.dupuytren-online.info/radiation_therapy.html and NA is Needle Aponeurotomy http://www.dupuytren-online.info/needle_aponeurotomy.html.

DD can be likened to an inflammatory healing response, and it often flares up as stated after surgery, and not just hand surgery. The bad news is some people also report a flare after NA or Xiapex, it's impossible to predict, but even so minimally invasive option to straighten contracture such as NA or Xiaflex are to be preferred, if clinically possible.

RT is a preventative in the early and active stages, not a prophylactic, but it slows or stops current active progression for most people. There is no cure, so avoid risk factors and with the recommended treatments most can manage it. The majority of people have slow progression and never get a contracture.

11/17/2018 13:38
carolyns 
11/17/2018 13:38
carolyns 
Re: can hand surgery cause Duypuytrens?

I am about to get surgery on my right hand for trigger finger - I had the left ring finger done 7 years ago and very shorty after DD appeared. I thought it was related to the surgery- although the dr. said it was hereditary. Non the less, I would like to prolong the onset, not encourage it. I am hesitant to get the right hand operated on now- since my trigger finger symptoms are just soreness and swollen-not so much the locking. I have had 3 cortisone shots over the last year that helped tremendously. I was looking for a more homeopathic method for dealing with the trigger finger- hence I found this forum.

I think I will cancel my surgery after reading that many patients have contracted DD shorty after their surgery.

11/17/2018 15:06
wach 

Administrator

11/17/2018 15:06
wach 

Administrator

Re: can hand surgery cause Duypuytrens?

Dupuytren's is indeed hereditary but that does not exclude that some things can foster it or slow it down. My view is that existing nodules start growing when the body is healing its wounds, which e.g. means that a lot of collagen is produced. That might be an explanation why new nodules appear for some patients and none for others. Worth noting that this kind of "disease extension" is the exception not the rule.

Wolfgang

carolyns:
I am about to get surgery on my right hand for trigger finger - I had the left ring finger done 7 years ago and very shorty after DD appeared. I thought it was related to the surgery- although the dr. said it was hereditary. Non the less, I would like to prolong the onset, not encourage it. I am hesitant to get the right hand operated on now- since my trigger finger symptoms are just soreness and swollen-not so much the locking. I have had 3 cortisone shots over the last year that helped tremendously. I was looking for a more homeopathic method for dealing with the trigger finger- hence I found this forum.

I think I will cancel my surgery after reading that many patients have contracted DD shorty after their surgery.

11/22/2018 21:12
Prof.Seegenschmiedt 
11/22/2018 21:12
Prof.Seegenschmiedt 

Re: can hand surgery cause Duypuytrens?

Thank you for the many different personal experiences with different types of trauma / hand or extremity surgery with subsequent development of Dupuytren Disease (DD).

In my long-term clinical experience with more than 1.000 Patients treated with radiotherapy for Early Stage DD only about 5% have had reported about a previous trauma or surgical treatment in the affected extremity, most of them were patients with carpal tunnel syndrome (CTS) and trigger finger syndrome, a few after a fractured bone and some after Reflex Sympathetic Dystrophy (RSD) syndrome.

Sometimes patients were affected parallel with both CTS and progressive DD: in those instances I recommended to perform the necessary surgical procedure FIRST followed after about 3 months by radiotherapy to stop the possible aggravation of DD.

It is always important to document the "progression" of the disease after a socalled "trigger trauma" carefully either by counting the number of nodules & cords or change of size of nodules and cords or changes of the surface of the hand palm (pit holes, wrinkles) or any functional changes of the hand etc. Only if these symptoms are obviously changing within a period of 3 - 6 months radiation therapy (RT) may be a good treatment option to stop progression.

------------------------------------------------------------------------------------------------------------------

With gratitude for all affected patients & medical colleagues who help to advance patient care ... Prof. S.

Edited 11/22/18 23:13

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