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Dupuytrens diagnosis after surgery
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05/20/21 23:47
Angel42773 
05/20/21 23:47
Angel42773 
Dupuytrens diagnosis after surgery

I’m a 48 year old female. Several years ago, I was diagnosed with carpal tunnel syndrome in my right hand. That’s my dominant hand so I put off surgery for as long as I could. Finally, in December 2019 I had it done. I had trouble healing and recovering from it and I attributed that to having diabetes. I went back to work as a material handler that unloads rail cars and tanker trucks of chemicals. In November of 2020, I began having issues where my right hand would contract and lock up while I slept. It was extremely painful and kept me from being able to do my job. In February, I finally admitted that I needed to see a doctor. I was referred to the same surgeon that did my previous hand surgery. He said I had 3 (index, middle, and ring) trigger fingers in my right hand. He did the release on March 5. Since then, my incision is completely healed, but the swelling in the pad under my ring and and middle fingers and the bottom of the fingers has never gone down. I also have been unable to straighten those fingers completely and they’re painful. I was sent for OT, but it hasn’t helped. A month ago, I developed a knot under my ring finger. The surgeon said it was more swelling and that he’d never seen someone react to the surgery the way that I did. He tried to manually force my fingers straight and accused me of fighting him. I only pulled away because it hurt. Earlier this week, I developed a different area of knotting directly under the first knot. I returned to the surgeon yesterday. He again tried to force my fingers open, told me that it was scar tissue and that there was no way that I couldn’t open my fingers more or make a fist. He finally examined both hands and found small nodules in my left hand, too, and said that I have Dupuytrens Contracture. He gave me a cortisone shot into the knot and said that it’ll help loosen the knotting and my fingers and he’d see me next month. I can’t bend or straighten my fingers all the way, I can’t lay my hand flat, I have what looks like a huge vein on the back of my middle finger that hurts and burns, my hand and fingers turns purple randomly, and I’m limited in my daily activities. What should I do from here? I don’t understand any of this. Any advice would be very much appreciated.

05/21/21 08:08
spanishbuddha 

Administrator

05/21/21 08:08
spanishbuddha 

Administrator

Re: Dupuytrens diagnosis after surgery

Angel42773:
I’m a 48 year old female. Several years ago, I was diagnosed with carpal tunnel syndrome in my right hand. That’s my dominant hand so I put off surgery for as long as I could. Finally, in December 2019 I had it done. I had trouble healing and recovering from it and I attributed that to having diabetes. I went back to work as a material handler that unloads rail cars and tanker trucks of chemicals. In November of 2020, I began having issues where my right hand would contract and lock up while I slept. It was extremely painful and kept me from being able to do my job. In February, I finally admitted that I needed to see a doctor. I was referred to the same surgeon that did my previous hand surgery. He said I had 3 (index, middle, and ring) trigger fingers in my right hand. He did the release on March 5. Since then, my incision is completely healed, but the swelling in the pad under my ring and and middle fingers and the bottom of the fingers has never gone down. I also have been unable to straighten those fingers completely and they’re painful. I was sent for OT, but it hasn’t helped. A month ago, I developed a knot under my ring finger. The surgeon said it was more swelling and that he’d never seen someone react to the surgery the way that I did. He tried to manually force my fingers straight and accused me of fighting him. I only pulled away because it hurt. Earlier this week, I developed a different area of knotting directly under the first knot. I returned to the surgeon yesterday. He again tried to force my fingers open, told me that it was scar tissue and that there was no way that I couldn’t open my fingers more or make a fist. He finally examined both hands and found small nodules in my left hand, too, and said that I have Dupuytrens Contracture. He gave me a cortisone shot into the knot and said that it’ll help loosen the knotting and my fingers and he’d see me next month. I can’t bend or straighten my fingers all the way, I can’t lay my hand flat, I have what looks like a huge vein on the back of my middle finger that hurts and burns, my hand and fingers turns purple randomly, and I’m limited in my daily activities. What should I do from here? I don’t understand any of this. Any advice would be very much appreciated.
Hi Angel, it is unfortunately quite common for Dupuytren's (DD) to first appear after surgery on the arm/wrist/hand. So although you may still have symptoms from the surgery you could also have early symptoms of DD. Based on what you have said so far I would seek out a different hand surgeon or Dr for further confirmation of the diagnosis, and suggestions for recovering from the surgery. A mix of scar tissue, swelling, inflammation and DD nodules or cords needs an experienced doctor or OT to help with recovery.

If you do have early DD, then there are several possibilities, it may settle down, it may continue to develop as nodules only, it may develop further as cords and into a contracture - if that is not the case already. Sore inflamed nodules can be treated, with some success with a steroid injection (triamcinolone), early DD can be treated with RT with 80% or so success in holding it back, but you may be advised to wait until surgical after effects have gone down.

I think you need help to ensure recovery from the surgery, scar tissue, swelling and flexion, whilst planning steps to take, if any, if your DD is confirmed and it continues to progress.

We have a list of Drs on our website that may prove a starting point, I would seek out one experienced in NA and surgery, and has an awareness of RT for advice on the next steps.

Best wishes SB

Edit to add, Dr Pess in NJ is the recommended Dr for you.

Edited 05/21/21 13:18

05/21/21 14:05
Angel42773 
05/21/21 14:05
Angel42773 
Re: Dupuytrens diagnosis after surgery

Thank you so much for responding. I see an amazing OT that has been more worried about the swelling, inflammation, and nodules than my surgeon has been. I have an appointment with my family practitioner to get a referral to someone for a second opinion. I look to see if anyone on the list is close to where I’m at. Thank you so much for the information.

06/21/21 09:24
gabrielluis 
06/21/21 09:24
gabrielluis 
Re: Dupuytrens diagnosis after surgery

It is common to have symptoms of Dupuytren's contracture after you have gone through surgery. Sometimes, knots of tissues get accumulated in the bottom of your fingers. The surgeon will diagnose the disease by looking at your hand and then by touching it. If you have early stages of Dupuytren's contracture, then there might be two possibilities: it may settle down, or it continues to develop as nodules. It may grow further as cords and into a contracture - if that is not the case already. Painful, inflamed nodules can be treated with some success with a steroid injection. If you are showing severe symptoms and cannot open your hand, you might need another surgery.

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