Dr. Steven Rueda is one of the most sought after doctors for Dupuytrens in Palm Beach. The hand condition is progressive in nature and requires careful followup from a hand specialist. It begins with lumps and pitting in the palms. There is subsequent development of contractures in the palm and fingers that show as tight bands in the direction of the fingers. As the disease progresses the finger joints become stiff and bent, therefore severely limiting the function of the hand.
WHAT CAUSES DUPUYTRENS DISEASE?
There is no one known cause for Dupuytrens, but rather several factors are thought to contribute to its development. The condition arises from abnormal thickening and contracture of the tissue below the skin and fat of the hand. This tissue is called the “palmar fascia” and extends throughout the palm and fingers. It is commonly seen in patient’s with northern European descent and was frequently seen in the Vikings. It is also more frequent in patients with diabetes.
DUPUYTRENS DISEASE PROCEDURE
There is no better surgery than others, and Dr. Rueda chooses the best procedure for each patient individually depending on current situation, need for fast recovery, and long term goals.
Incisions
Needle puncture sites along the course of the tight band spaced by 0.5-1.0cm
Incisions
Made vertically along the course of the tight band in a zig-zag pattern
Frequently Asked Questions (FAQ)
Patients with progressive contracture of the joints that limits daily activities are good candidates for procedural intervention.
It is common to have recurrence after Dupuytrens disease surgery. The lowest rate of recurrence occurs with open surgery, followed by needle fasciotomy. The recurrence rate after Xiaflex the highest, with most patient’s presenting with persistent symptoms at 2 years.
For Xiaflex the main risks are swelling, redness, and open wounds. Fortunately, open wounds heal well and quick with dressing changes. For the surgical alternatives the main risks remain damage to tendons, nerves, arteries and veins that are entrapped on the diseased tissue.