I tagged this post as an injury but Dupuytren’s contracture is not really an injury. It is an abnormal thickening and tightening of the normally elastic tissue beneath the skin of the palm and fingers. This tissue, fascia, contains strands of fibers, like cords, that run from the palm upward into the fingers. When these cords tighten, or contract, it causes the fingers to curl forward. In severe cases, it can lead to crippling hand deformities.
This is why Steve had to have surgery on his hand on the 7th of August. The Dupuytren disease had been getting worse over the years and got to the point he no longer could straighten his pinky finger straight out. It had also become very painful and was becoming harder for him to do certain things with his hand.
The cause of Dupuytren’s disease, is unknown, but certain biochemical factors that affect the palm’s connective tissue may be involved. Injuries and overuse of the hand do not play a role. Tendons are not affected. However, certain things may make it more likely to develop Dupuytren’s disease. They include: drinking a lot of alcohol, diabetes, seizures and smoking. The condition is also inherited. People with Northern European (English, Irish, Scottish, French, Dutch) or Scandinavian (Swedish, Norwegian, Finnish) background.
Steve’s had become an advanced cases of Dupuytren’s, therefore, surgery was required. In this procedure, an incision was made in the hand and pieces of the built-up chords or bumps were removed. Following the surgery, he needed to wear a hand split. This picture was taken in the recovery room, about an hour after coming out of surgery. When I came into the recovery room, Steve was no where to be seen, just an empty wheelchair. The nurse said “He’s in the restroom.” and I replied with “Of course he is.” When he walked out I laughed out loud. They said he would have a splint but no where in my mind did I think it would be this large.
During surgery Debbie, our niece from Georgia, sat with me. It made the two and half hour surgery go very fast. It was wonderful to have one on one conversation with her over breakfast sandwiches in the VA Cafe. When Steve and I came out of the recovery room, this is the photo Debbie snapped. After his other surgeries, he had always had to be taken down to the curb in a wheelchair, this was not the case this time. Debbie and I walked him down to the car in the parking lot.
Steve after surgery instructions were to keep his hand above his heart level and to ice it. This was to help with the pain and swelling. This picture was taken later in the day on the 7th, Wednesday. He was doing great until Friday evening when he went into a panic attack because he could not move his fingers. He tried walking it off, all most screaming and finally reached to pull the bandage off. I was able to talk him down and suggested taking some CBD to see if it would help. He seemed to calm a little after the CBD but took a sleeping pill and one of his pain pills to speed the process. He had not taken any pain pills since Wednesday night. On Saturday night, about the same time as the previous night, another attack came over him. A dose of CBD and the attack did not reach the level it had before.
On Monday, August 12th, we went back to the VA for his followup. The doctor removed the splint and uncovered the incision. It looked just like the doctor had described before surgery. The only thing we didn’t know was which one of the drawings the doctor had decided to do. The purple markings shows where he had traced a path for one option for opening up the hand. The stitching is on his other traced path. The lower right hand purple is the word yes, meaning this is the hand they were going to do surgery.
This was Steve’s new splint, which he could remove whenever he wanted to and did not have to wear it full time. He could also get it wet now. His PT was to be able to make a fist by the time we go back in four weeks. He was able to use his computer, sign things and go into the pool with a plastic sack on his hand. Amazing he could type just five days after surgery!
His hand is healing well but looks a little rough. He does well making his fist, needs just a little more for the pinky to get there. He is having more pain and stiffness than he was having. VA checked on him the other day and she said that was “normal”. He has two more weeks before his next check up.
The Dupuytren disease can come back in about 10 years but may not. My Dad also had this but it was his ring finger that was affected. He too could not flatten his hand on a table. I have the beginnings of the disease on my right hand. No drawing of the fingers and the palm is only showing small signs. Hoping it doesn’t process like Steve’s did and that his does not come back.