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Dupuytren’s Contracture (palmar fibromatosis)

benign condition dupuytrens contracture

About Dupuytren's Contracture

Dupuytren's contracture is a common condition that causes thickening and tightening of the fibrous tissue beneath the skin on the palm of the hand, resulting in pain in the hand and fingers. It is also known as Viking disease, Celtic hand, or palmar fibromatosis, and is best described as having a claw hand or curled up fingers. Over time, the usually soft tissue becomes thickened and contracted, producing tight cords or nodules under the skin. These progressively cause the ring finger, and often fifth finger, to bend permanently. In the early stages, the disease can be quite subtle, but it is commonly found to be more extensive than initially suspected when assessed.

The main treatments for Dupuytren's contracture, as listed by the International Dupuytren Society (in stage order), are:

  1. Radiation therapy
  2. Needle aponeurotomy
  3. Collagenase injection
  4. Hand surgery

In the early stages, radiation therapy provides the most effective benefit, but in advanced stages surgery may be necessary to remove the harder cords and surrounding tissue.

Radiation therapy for Dupuytren's Contracture

Low dose radiation therapy has a long history of use in patients with Dupuytren's contracture. It is most effective when delivered relatively early during the disease's progression at the nodule or cord phase, rather than in the fibrotic phase.

Treatment is delivered in five outpatient sessions over 1-2 weeks followed by a 6-12 week break, and then a further five sessions. Each session lasts approximately 15 minutes, is not painful, and does not cause significant side effects. There may be some mild redness of the skin immediately following treatment, but this usually disappears over 2-3 weeks.

The success rate is high for disease control if radiation is delivered during the early stages of the disease. 1

How does radiation therapy work?

In the early phases, Dupuytren's contracture is an inflammatory condition. Low dose radiation therapy targets inflammatory cells and reduces the chance of subsequent scarring that leads to contractures.

Ledderhose disease (plantar fibromatosis), is a similar condition that occurs in the feet. It can also be treated with low dose radiation therapy.

If you'd like to talk to a GenesisCare radiation oncologist about treating a benign condition, click here to find your local area specialist.

Reference:

1 Adamietz B, Keilholz L, Grünert J et al. Die radiotherapie des morbus Dupuytren im frühstadium mangzeitresultate nach einer medianen nachbeobachtungszeit von 10 jahren. Strahlenther Onkol 2001; 177(11): 604-610.

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