Dupuytren's contracture

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APACHE3

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Ok, so I'm changing my winter tires to summer tires with my father-in law. I notice a big "callous" on his hand and ask him about it. I then exam a little closer and see its more than just a callous. he then tells me his father had the same thing and his brother has it too!! ding, ding, I'm sure its Dupuytren's contracture. His case is mild, at this stage. Does cortisone intervention in the early stages improve outlook? he's still active and has no compaints about it. I presume surgery is in the future, but when. Any thoughts?
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APACHE3 said:
Ok, so I'm changing my winter tires to summer tires with my father-in law. I notice a big "callous" on his hand and ask him about it. I then exam a little closer and see its more than just a callous. he then tells me his father had the same thing and his brother has it too!! ding, ding, I'm sure its Dupuytren's contracture. His case is mild, at this stage. Does cortisone intervention in the early stages improve outlook? he's still active and has no compaints about it. I presume surgery is in the future, but when. Any thoughts?
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No cortisone doesn't help. He should seek out a hand surgeon in the area. When he decides enough is enough with the contracture, then that is the time to seek surgical intervention. ( however, the earlier the stage the easier the surgery) They all come back but the reoperative rate is lowish (but still significant 20-30%), and it is a dangerous surgery from an anatomical standpoint. The myofibroblasts can really distort the anatomy and put the Neurovascular bundles in the fingers at risk that could result in perm. post op numbness or even intraoperative amputation. (even more common in reoperation)
 
there is no contracture as of yet. Just a noticeable "pinched lump" of hard skin over the medial palm under digits 4,5. he can still do wood work, home plumbing, contruction. he nevers complains. I think I read about a palm to table test, so I'll just keep an eye on it, but I think he's years away from surgery, especially with the neurovascular risk that might entail. thanks
 
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