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can hand surgery cause Duypuytrens?
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05/17/10 22:04
dooleygreen 
05/17/10 22:04
dooleygreen 
can hand surgery cause Duypuytrens?

Hello,
I am in a world of hurt. I had hand surgery on January 4th,2010. I developed RSD as a result of the surgery. I had no symtoms of Duypuytrens prior to the surgery. There was no mention of it by the hand surgeon or my GP. After a very aggressive physical therapy session, I awoke the next day with a "sprung hand" The tendons in my hand (especially my thumb) were suddenly contracted. The pain from the RSD is constant. After seeing two hand orthos (all in Kaiser) the third ortho informed that I have
Duypuytrens. Can you trigger an onset of this disease from surgery if no previous symptoms were apparent?

Thank you for any info.

Dooley Green

05/18/10 16:39
mccn 
05/18/10 16:39
mccn 
Re: can hand surgery cause Duypuytrens?

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.

12/21/10 14:38
QZTRGQ

not registered

12/21/10 14:38
QZTRGQ

not registered

Re: can hand surgery cause Duypuytrens?

mccn:
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.


I, too, had no symptoms, until, about thirty years ago, which in turn was about 10 years after a motor accident, which resulted in the trauma of temporary amnesia, and the first finger of the right hand locked in grip. This was moved back into position by me after application of a degree of pressure. Doctors at the time identified the complaint as Duypuytrens, (known as the Vikings complaint) and recommended a period of physiotheraphy.
Since then, continuing excercise has had little effect, and gradually the tendons have become increasingly prominent on both hands, and the gripping strength, on both hands, has decreased. I can cope in most situations, having bought can and bottle opening tools, and, whilst from time to time there is a degree of pain in the first finger of either hand, and a degree of humiliation, without the tools, not being able to apply the necessary pressure from either hand, I have accepted the situation, and have a near normal relationship with situations that require manual dexterity. A maternal Aunt has the same complaint...she is now 95 years of age, and I am almost 70, so, evidence suggests that, while this is inconvenient, it is not a life threatening complaint.

12/21/10 20:45
callie 
12/21/10 20:45
callie 
Re: can hand surgery cause Duypuytrens?

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.

12/22/10 10:08
newman 
12/22/10 10:08
newman 

Re: can hand surgery cause Duypuytrens?

Hi Australia Calling.Many patients with Dupuytrens also develope trigger finger. In my case the surgery started the clock ticking for the next surgery. Thats why NA is the better option once there is contraction. I was at the Conference in Nuremberg Germany in October where one of the Surgeons stated he would always opt for NA in the first instant before any surgery . Check what Prof. Ilse Degreef says in her video. She received the Dupuytren Society award for 2010.

Regards.

12/22/10 17:29
David26

not registered

12/22/10 17:29
David26

not registered

Re: can hand surgery cause Duypuytrens?

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.

04/09/16 17:07
jimbob0802 
04/09/16 17:07
jimbob0802 
Re: can hand surgery cause Duypuytrens?

Hi

I know this post was originally from 2010 but hoping someone can answer.

I seemingly have DD in my left hand - I say seemingly, because even now I'm trying to reconcile the fact that he nodule and cord I've developed are on my left hand pinky finger...which happens to be the same place where I had surgery to correct a trigger finger 17 years ago (I'm 33 now).

The nodule and cord are huge - but I can still flex my fingers straight no problem. The question I would like to ask is 'can trigger finger caused dupuytren's?' I know that Dupuytren's can cause trigger finger - but what about the other way round? I can't find an answer to this question.

Thanks in advance,

Jimbob

04/09/16 17:40
Stefan_K. 
04/09/16 17:40
Stefan_K. 

Re: can hand surgery cause Duypuytrens?

I have concluded from what I have read and experienced on one of my hands that any bleeding wound to a hand, whether from an accident or from surgery, can speed up the development of nodules and cords in an individual with a genetic predisposition to Dupuytren's disease.

How many years after your surgery did you notice your first nodule?

Stef

[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]

04/09/16 17:56
jimbob0802 
04/09/16 17:56
jimbob0802 
Re: can hand surgery cause Duypuytrens?

Hi Stefan

As ever thanks for replying.

So I had my surgery for trigger finger in 1999-2000 - can't remember exactly when. I can't remember doing any other treatment before either, nor any rehab after. In hindsight, I think I got a raw deal here - from the looks of it an injection would have been the way to go.

Obviously I've had a scar from that surgery ever since, but probably noticed it getting 'inflamed' or 'bulky' for the first time a couple of years ago, or maybe between 12-18 months. Certainly nothing I was bothered about.

Then:

Summer 2015 - I was seeing the doctor quite regularly about the back and neck issues I've developed, and he visibly noticed by hand and said that it looked like I had Dupuytren's. I was like, "what?!". He advised that I keep an eye on it and stretch it out daily.

Around Dec 2015 I asked to see a hand specialist about it because I was getting pins and needles in my hands, and quite a lot of weakness and numbness. Personally I thought I had Carpal Tunnel Syndrome, but by the time Jan 2016 came round I had got on top of that. The hand specialist said it Dupuytren's, was 'jolly interesting' and that he would do surgery if 'I pushed him'.

If I knew what I know now I would have pushed him...over. In the last few months the nodule and cord has become more pronounced, to the extent that I'm now actively investigating options - before things like RT move over to surgical means. If only I'd known about all this stuff a while back - alas, c'est la vie - I'm grateful for finding you guys.

I know you've seen it before anyway, but photo of my left hand is attached...the trigger finger scar is along the heart line.

Jim

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04/09/16 19:01
Stefan_K. 
04/09/16 19:01
Stefan_K. 

Re: can hand surgery cause Duypuytrens?

Hello Jimbob, I am just another fellow patient with a little head start on reading and treatment, but 15 years later doesn't sound to me like a compelling link to your previous surgery. Can't turn back the wheel of time anyway, just make the best of what you have moving forward. If as it sounds your progression is currently rapid it does make sense to look into RT options before nodules and cords grow too much and harden. Good luck!


Stef

[54 year-old male, DD diagnosis 2006, RH contracture and NA/PNF 2014, RT 2015, wearing night splint glove]

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