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Thumb trauma and Dupuytren’s
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07/07/2024 15:41
janegould2000 
07/07/2024 15:41
janegould2000 
Thumb trauma and Dupuytren’s

I badly sprained my thumb 28th September and partially tore the ligament, this was not properly diagnosed till the 1st Feb, I have subsequently been doing intensive physio at the Pulvertaft Centre Derby and at home. February I noticed my first nodule, I was diagnosed last month and I now have two nodules, cords to 3 fingers and my thumb, at least two of my fingers are contracting, has anyone been in a similar situation?, there saying my thumb will take 12-18 months of physio to get as good as it can be, then the Duputrens being in that many fingers and the dreaded thumb

Edited 07/08/2024 17:51

07/07/2024 18:59
spanishbuddha 

Administrator

07/07/2024 18:59
spanishbuddha 

Administrator

Re: Thumb trauma and Dupuytren’s

Hi Jane

Sorry to hear your news. Hand trauma of various sorts, but usually surgery such as carpal tunnel or wrist/finger breaks is often the precursor of DD. You don't give your age or any family hereditary history? Maybe it will settle down, but it sounds like it is progressing. I would in your case ask advice of Mr Chris Bainbridge at the Pulvertaft.

Having said that check out our Treatment pages for some early treatment options, look at the Radiotherapy pages and Other Therapies pages. Have a browse of the forum or search within for 'trauma' for personal stories. You could also review the British Dupuytrens Society site who have an active Facebook group with Trustees from the UK including leading Drs and there are lots of personal stories there too.

Best wishes SB

07/08/2024 04:58
janegould2000 
07/08/2024 04:58
janegould2000 
Re: Thumb trauma and Dupuytren’s

Hi
I’m 54, female, no family history, the hand surgeon who diagnosed Dupuytrens said it was linked to the trauma in my thumb. I have been reading a lot of posts and researching, I’m going for my physio shortly at Derby Royal and I’m going to ask for a follow up appointment as it does seem to be progressing. I’m also going to ask the physio today if she can measure my hand as I believe you can’t receive treatment until you have 30 degrees of contracture, I can’t put my hand down flat, but 30 degrees, not sure.
Thanks for your help and will ask for that doctor if possible

07/08/2024 05:17
spanishbuddha 

Administrator

07/08/2024 05:17
spanishbuddha 

Administrator

Re: Thumb trauma and Dupuytren’s

janegould2000:
Hi
I’m 54, female, no family history, the hand surgeon who diagnosed Dupuytrens said it was linked to the trauma in my thumb. I have been reading a lot of posts and researching, I’m going for my physio shortly at Derby Royal and I’m going to ask for a follow up appointment as it does seem to be progressing. I’m also going to ask the physio today if she can measure my hand as I believe you can’t receive treatment until you have 30 degrees of contracture, I can’t put my hand down flat, but 30 degrees, not sure.
Thanks for your help and will ask for that doctor if possible
Most surgeons will say no treatment until there is a contracture. But if you read our treatment pages there are a few options to slow down or halt progression before a contracture. RT is the one with a good deal of evidence behind it. Difficult to get on the NHS but not impossible; the BDS FB group will give examples. If you do have 30 degrees of contracture it may be too late for RT and so NA might be the next option; Mr Bainbridge will advise. A triamcinolone steroid shot if nodules are inflamed helps a lot of people too. After that there are less evidence based options that some people say help but rarely provide follow up posts or reports so take any ideas of cures with creams, wands, lasers, ultrasound with a pinch of salt. Happy to answer specific questions. SB

07/08/2024 06:38
janegould2000 
07/08/2024 06:38
janegould2000 
Re: Thumb trauma and Dupuytren’s

Hopefully I can get an appointment for next week after my physio, I probably feel it’s too late for rt, after reading up about things my next thought was the needle treatment, but like you say there are other options. Also I might ask about night splints, there does seem to be mixed feelings about these, do you have any thoughts? Thanks for your help

Edited 07/08/2024 06:43

07/08/2024 07:40
spanishbuddha 

Administrator

07/08/2024 07:40
spanishbuddha 

Administrator

Re: Thumb trauma and Dupuytren’s

janegould2000:
Hopefully I can get an appointment for next week after my physio, I probably feel it’s too late for rt, after reading up about things my next thought was the needle treatment, but like you say there are other options. Also I might ask about night splints, there does seem to be mixed feelings about these, do you have any thoughts? Thanks for your help
I personally don't think splinting will stop ongoing progression prior to any procedure such as NA or surgery. But it's easy to do overnight and you have nothing really to lose by trying it. I used to wear a Fixxglove overnight but no longer bother. You could ask your physio to make up a splint for you to try. There are debates about the usefulness of splinting after NA or surgery, as you can see from our website and the arguments for and against at one of our conferences.

Taken from another post: The Dupuytrens conference and book had a topic on this as a ‘controversy’ on which two different sides expressed an opinion. You can find these talks, for and against, on YT. https://youtu.be/2-Ad4vp1EOA Having said that most patients posting on this topic in our forum are in favour and report benefits. We have a page about this on the website https://www.dupuytren-online.info/dupuyt...-splinting.html

Edited 07/08/2024 09:55

07/08/2024 11:02
janegould2000 
07/08/2024 11:02
janegould2000 
Re: Thumb trauma and Dupuytren’s

I spoke to the physio and she said there not in favour of splinting overnight, she also said I’m at 22 degrees on two fingers, so she’s going to monitor it, I’ve made an appointment next week with one of the hand surgeons as the cord going to my thumb is intersecting with a lump I have which is something to do with the torn ligament Who would of thought falling over your dog could cause so many problems 🤦🏼‍♀️

Edited 07/08/2024 18:16

07/08/2024 15:27
spanishbuddha 

Administrator

07/08/2024 15:27
spanishbuddha 

Administrator

Re: Thumb trauma and Dupuytren’s

janegould2000:
I spoke to the physio and she said there not in favour of splinting overnight, she also said I’m at 22 degrees on two fingers, so she’s going to monitor it, I’ve made an appointment next week with one of the hand surgeons as the cord going to my thumb is intersecting with a lump I have which is something to do with the torn tendon. Who would of thought falling over your dog could cause so many problems 🤦🏼‍♀️
Hopefully you are or will be a candidate for NA rather than surgery (fasciectomy) although there can be clinical reasons why surgery is favoured over NA. My point is if possible push for NA if treatment is suggested at this stage.

Then maybe start thinking about any post NA or surgery treatment as whilst the condition is progressing this can just cause further or new nodules. This comes full circle to trauma (including surgery) causing DD. Ask about this possibility. Exercises, scar management, compression splinting, are all things that might help if there are signs of re-contracture, but for new nodules probably either steroid shots, or RT are the options, and although there are anecdotal reports of RT helping post NA/surgery I don't think the evidence is there yet. I myself would in your case research the pathway to RT now, so that if after NA or surgery there are new signs of progression you are ready to follow up. But, let's hope that this wont be necessary for you. SB

07/08/2024 17:07
janegould2000 
07/08/2024 17:07
janegould2000 
Re: Thumb trauma and Dupuytren’s

Yes that is very interesting, in the 4 weeks I’ve been researching everything things really progressed so fast.
I’m going to ask about RT in the appointment on Monday, even though it probably is too late for the situation I’m in now, so NA is the next option, hopefully not surgery. If they don’t do RT at Derby, makes you wonder if they don’t cause I was literally told come back when your at 30 degrees, I will find out where you can get that treatment, I have read somewhere there is a doctor in Poole, Dorset. Hands are so complicated and once you start getting problems it really does seem a vicious circle you find yourself in.

Edited 07/08/2024 17:40

07/08/2024 17:15
spanishbuddha 

Administrator

07/08/2024 17:15
spanishbuddha 

Administrator

Re: Thumb trauma and Dupuytren’s

janegould2000:
Yes that is very interesting, in the 4 weeks I’ve been researching everything things really progressed so fast.
I’m going to ask about RT in the appointment on Monday, even though it probably is too late for the situation I’m in now, so NA is the next option, hopefully not surgery. If they don’t do NA at Derby, makes you wonder if they don’t cause I was literally told come back when your at 30 degrees, I will find out where you can get that treatment, I have read somewhere there is a doctor in Poole, Dorset. Hands are so complicated and once you start getting problems it really does seem a vicious circle you find yourself in.
Not sure about RT at Poole on the NHS. The BDS is more up to date see here and their Doctors page https://dupuytrens-society.org.uk/treatm...rapy-treatment/

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surgery   triamcinolone   Treatment   contracture   dupuytren-online   🤦🏼‍♀️   Dupuytren’s   intersecting   ‘controversy’   appointment   rapy-treatment   researching   re-contracture   Dupuytrens   degrees   progression   dupuytrens-society   Hopefully   janegould2000   progressing