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Dupyutren's or Hand Injury Complication?
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07/18/20 22:17
Jaykson2 
07/18/20 22:17
Jaykson2 
Dupyutren's or Hand Injury Complication?

When I was 12 I tore the middle tendons in the pinky finger and I was unable to straighten my pinky finger past 45 degrees for years. When I was 15 I went and got physical therapy and they straightened the finger out with a splint. After PT I could straighten it but it requires effort compared to the other fingers and my pinky still kind of looks deformed. Ever since my teens and early 20's I noticed that I would get a callous in my palm in my palm below the pinky finger on that side and I can feel that cord in the palm on that side. I always thought this problem was just because my finger was stuck in a bent position and I still have to strain to staighten it but recently learned of Dupyutren's and am wondering if it could be that. I know I need to get a doctor's diagnosis but was wondering if my situation sounds more like Durpyutren's or a complication from having a finger that doesn't work as well due to injury. I know teens would be young for this disorder. I can provide a picture if that would help. Thanks!

07/19/20 10:03
spanishbuddha 

Administrator

07/19/20 10:03
spanishbuddha 

Administrator

Re: Dupyutren's or Hand Injury Complication?

It is too hard to say. Any other symptoms in that hand such as nodules or dimples? The callous you describe, does it come and go? If you had a tendon injury that was not repaired by surgery you could be feeling the results of that, fibrous tissue or scarring, and not a cord. In general with a DD contracture you cannot straighten the cord except with a lot of force resulting in 'breaking' it with associated pain and bruising. By all means post a photo but yes you need a hand specialist diagnosis.

07/19/20 10:23
Jaykson2 
07/19/20 10:23
Jaykson2 
Re: Dupyutren's or Hand Injury Complication?

It doesn't come and go and it is kind of like a nodule. I attached a picture of my palm and one of my pinky since it shows it is still deformed from the tendon tear even though it can straighten after Physical Therapy. So it is possible to have fibrous tissue or scarring that is not Dupyutren's?

Attachment
Finger.jpg Finger.jpg (3x)

Mime-Type: image/jpeg, 526 kB

Palm.jpg Palm.jpg (6x)

Mime-Type: image/jpeg, 1.184 kB

07/19/20 13:21
spanishbuddha 

Administrator

07/19/20 13:21
spanishbuddha 

Administrator

Re: Dupyutren's or Hand Injury Complication?

If you can straighten the finger after PT or, say, with the other hand it is not a DD cord causing the bend. I have something similar and it is a combination of scar tissue and permanent joint restriction from an injury. Yours maybe similar.

The calluses are interesting, but from the photo look more like calluses than nodules. Are they on the skin surface or below; are they tender? Nodules tend to form below the skin, can be sore, inflamed and 'angry' with other symptoms such as itching, tingling. An experienced hand surgeon would be able to tell the difference from feel.

So far it doesn't seem to be DD, but this is not to be taken seriously since it's based on your description, the photos which aren't too clear, and anyway IANAD.

I have a similar problem with my third finger, it's unnaturally bent but I can straighten it, some small nodules along the finger (I do have DD in that hand), lots of scarring, and have to regularly stretch it manually to maintain flexion. My hand surgeon has an associated physio team who do mainly hands and wrists only as a speciality, maybe you have access to a similar group for support and treatment, not forgetting diagnosis?

07/19/20 23:24
Jaykson2 
07/19/20 23:24
Jaykson2 
Re: Dupyutren's or Hand Injury Complication?

spanishbuddha:
If you can straighten the finger after PT or, say, with the other hand it is not a DD cord causing the bend. I have something similar and it is a combination of scar tissue and permanent joint restriction from an injury. Yours maybe similar.

The calluses are interesting, but from the photo look more like calluses than nodules. Are they on the skin surface or below; are they tender? Nodules tend to form below the skin, can be sore, inflamed and 'angry' with other symptoms such as itching, tingling. An experienced hand surgeon would be able to tell the difference from feel.

So far it doesn't seem to be DD, but this is not to be taken seriously since it's based on your description, the photos which aren't too clear, and anyway IANAD.

I have a similar problem with my third finger, it's unnaturally bent but I can straighten it, some small nodules along the finger (I do have DD in that hand), lots of scarring, and have to regularly stretch it manually to maintain flexion. My hand surgeon has an associated physio team who do mainly hands and wrists only as a speciality, maybe you have access to a similar group for support and treatment, not forgetting diagnosis?

I am a weightlifter so that is why my hand has all the calluses up top. The palm is an odd place to get a callus but if you look closely at my picture you can kind of see there is a cord like line protruding from the pinky finger on down. I think that being raised might cause a callus to develop more easily there (even from non weightlifting activities). Not sure if it is Dupyturen's but when I google symptoms it comes up as the top search. I guess it is hard to say because I am had a hand that has had issues since I was a kid which could certainly cause other issues to arise or maybe the injury triggered a teenage case of Dupyutren's. I will see a doctor at some point but it is harder right now with covid so I thought I would run it by you all since it isn't urgent or dangerous

Edited 07/19/20 23:38

07/20/20 09:51
spanishbuddha 

Administrator

07/20/20 09:51
spanishbuddha 

Administrator

Re: Dupyutren's or Hand Injury Complication?

Jaykson2:
I am a weightlifter so that is why my hand has all the calluses up top. The palm is an odd place to get a callus but if you look closely at my picture you can kind of see there is a cord like line protruding from the pinky finger on down. I think that being raised might cause a callus to develop more easily there (even from non weightlifting activities). Not sure if it is Dupyturen's but when I google symptoms it comes up as the top search. I guess it is hard to say because I am had a hand that has had issues since I was a kid which could certainly cause other issues to arise or maybe the injury triggered a teenage case of Dupyutren's. I will see a doctor at some point but it is harder right now with covid so I thought I would run it by you all since it isn't urgent or dangerous
I took another look, and can see the callus mid palm, with a hint of a cord and dimpling, so indeed maybe early signs of DD. Since trauma is implicated with DD have you looked at wearing gloves or improving existing gloves for weightlifting? I would keep an eye on hints of progression in case it is DD, measure your hand and finger extension flexion now and check it every now and then.

07/20/20 10:05
Jaykson2 
07/20/20 10:05
Jaykson2 
Re: Dupyutren's or Hand Injury Complication?

Yeah it does seem like it could be DD, possibly got it so young due to the trauma. I have had it for about 15-20 years at this point I just never knew a name for the condition. I got it around my mid teens and now am in my early 30's It hasn't progressed in the past couple decades so could it have stabalized or does this condition not really stop? Maybe that means I don't have a bad case or that it is going to progress really slowly? I might start wearing gloves if the condition ever limits my lifting or grip.

07/20/20 10:24
spanishbuddha 

Administrator

07/20/20 10:24
spanishbuddha 

Administrator

Re: Dupyutren's or Hand Injury Complication?

If it is DD then since you are susceptible, then at some time in the future it may progress further. It's really hard to say or predict individual cases. But forewarned is forearmed, there are related risk factors https://dupuytrens-society.org.uk/information/risk-factors/ you could make efforts to avoid where possible, and there are treatment options if caught early and before significant contracture. An early sign of new progression might be new nodules, that one nodule becoming sore, or strange itching or tingling in the palm.

07/21/20 01:24
Jaykson2 
07/21/20 01:24
Jaykson2 
Re: Dupyutren's or Hand Injury Complication?

I was reading about hand injuries and DD and came across this https://dupuytrens.org/dupuytren-literature-injury/
Apparently there is something called Pseudo Dupyutrens that develops after injury that resembles dupyutrens but doesn't lead to contracture. I think there is a good chance I probably have DD but I guess it is hard to say for sure with my hand injury history. Do you think an internal medicine doctor diagnose it or am I going to need to find a specialist?

07/21/20 09:26
spanishbuddha 

Administrator

07/21/20 09:26
spanishbuddha 

Administrator

Re: Dupyutren's or Hand Injury Complication?

I would seek a hand surgeon who has lots of experience with DD, performing NA, Xiaflex or various forms of surgery. Dr Denkler comes to mind and is 'close' to you but thats really quite a drive just for a diagnosis. If you search the forum a Dr David Evans in Sacramento gets mentioned.

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