Therapy of the Dupuytren's Disease


	Dupuytren's Disease

Therapy
The following information for patients concerning the therapy of
Dupuytren's Contracture shall not disengage you to take medical advice.

Is it necessary to make an analysis or to x-ray the hand before proceeding the therapy?	The mentioned treatment is unnecessary for most of the patients. It may be useful to x-ray severe forms of Dupuytren's Disease in order to plan the surgery especially if the fingers are bent. The attending physician has to decide from case to case if an analysis, e.g. for diabetes mellitus, seems necessary. Consultation of a neurologist is appropriate if the patient is suspected of suffering from epilepsy or from nerval compression.
Is it possible to cure Dupuytren's Contracture by injections, laser or ultrasound?	The effectiveness of such treatment is not scientifically proven.
Is there a medication to cure Morbus Dupuytren?	The pharmaceutical industry has made large efforts to prove their products in clinical trial, best known is vitamin E. It is also true for vitamin E that the effectiveness is not scientifically proven. Individual patient's experience may differ from the clinical trial: Some years ago a patient who was suffering from both, Dupuytren's Disease and a deformation of the erected penis (Induratio Penis Plastica), has told me about his vitamin E medication advised by his urologist. The patient did not know that both diseases have something in common. He explained that he did not recognise any progress concerning the symptoms of his penis. On the contrary he noticed that the cord in his palm became softer and less disturbing for him.
I have heard about the treatment of Dupuytren's Disease with x-rays. Is that effective?	Radiation therapists who provide this treatment bring forward the argument that radiation damages a special form of cell, the fibroblast, which is involved in the progression of Dupuytren's Disease. It is very hard to find evidence for their argument. The efficiency is very controversial due to the fact that it is impossible to collect verifiable data. The disease may stagnate for months or years even without any treatment. On the other hand one ought to consider the possible negative consequences of such a radiation therapy: A radiation injury of the skin may occur Higher dose of radiation and/or treatment for longer periods may cause cancer. The guidelines of the German Association for Hand Surgery call this therapy method obsolete (out of use).
Is it always necessary to treat Dupuytren's Contracture by means of surgery?	No ! Surgery will only be considered in case of a serious affection of the ability to extend the fingers. Exception: If you are suffering from pain or feel disturbed by several cords or lumps a surgery can make sense as well.
What shall I do if I am only suffering from a single cord or lump in the palm?	In that case surgery would not be appropriate. Instead the hand surgeon will monitor the development of Dupuytren's Disease every 12 - 18 months.
Do I always have to stay in hospital after the surgery of Morbus Dupuytren?	No! Nevertheless, the hand surgeon has to examine you in order to form the decision whether ambulant treatment or clinical treatment is suitable. Ambulatory treatment is appropriate for: patients who are suffering from other diseases patients who do not have the adequate treatment opportunities at home patients who need more operating time due to their more severe form of the ailment