Hand Surgeon Questions Hand Injuries and Disorders

Depuytren's contacture question

I have Depuytren's contracture in both of my hands. I have heard that radiation therapy can help. How does this help? Does it really help?

12 Answers

Dupuytren's contracture is not normally treated with radiation therapy. It comes in all different patterns of severity and often requires surgery. Recently there have been some new options with injections of collagenase enzyme or what is called a percutaneous fasciotomy (cutting the cord with the bevel of a needle inserted through your anesthetized skin). You need to see a hand surgeon for recommendations as to the most appropriate treatment.
Although radiation treatment is described for Dupuytren's disease, it is not a first line treatment. First line treatment for Dupuytren's disease that results in a contracture is either surgery or a Xiaflex (Collagenase) injection. In terms of surgery, there are a number of options, one of which is minimally invasive - called needle aponeurectomy. Radiation therapy is rarely indicated, and usually only in refractory cases that have recurred after the above first line treatments.
There is a national institutes of health study which pretty much states that about 3/4 of the people treated with appropriate radiation therapy do not progress to any worse stages if they are treated early. You need to really discuss this with your radiation therapist however.
There is some literature that supports the use of radiation in Dupuytrens contracture. I don’t recommend it to my patients because of potentially adverse effects on the hand. And it’s unlikely to reverse a contracture.

Harrison Solomon, M.D.
There are several hand doctors that you are special procedure for Dupuytren contractures
I have not heard that radiation therapy helps at all I would recommend you see a hand doctor that actually does this procedure you can Google it
Dupuytrens responds very well to needle aponeurotomy, which is a simple in-office procedure done by a hand surgeon. I would recommend this over surgery and over radiation therapy.
Radiation therapy has been popular in countries such as Germany for many year and recently NHS trials are undergoing in Great Britain IN the US there are indivudual practitioners who offer this and some are enrolled in well contracted trials ( where the results are monitored for efficacy) The literature typically states that radiation may be helpful for early nodules but not if cords have started to form. There are many treatments avaialabel for DUpuytrens, some are for early nodules but the bulk are for cord formation associated with contracture. There are many variables in terms of hereditary, and outside factors that affect how Dupuytrens will play our but iit is very hard to predict who will be held at a ny ally stage, thus the need for more well crafted clinical trials for Radiation. seek out additional information from http://www.dupuytren-online.info and https://dupuytrens.org as well as our website http://www.handctr.com/dupuytrens-disease-faq.html and also www.assh.org to find a hand surgeon in your area
I have not heard that radiation helps dupuytren's contracture which is excess collagen of the cord in the palm. Two options would be surgery or if there is a palpable cord, you may be a candidate for Xiaflex injection which would dissolve the cord without surgery. An evaluation would have to be done to determine treatment,
Low dose radiation has been shown to be helpful in Depuyten's contractures. It is used routinely in England. It is rarely if ever used in the USA and is not covered by insurance.
Although there is an institution in DE that is currently accruing data on this subject, the only published data is from a single institution in Germany. It has only been shown to affect very early Dupuytren's and I feel that the risks outweigh the benefits when there are injection and surgical procedures available.
Dear Sir or Madam,

Sorry to hear you're struggling with this. I am a diagnostic radiologist
and neither a radiation oncologist nor hand surgeon. With that being said,
from what I know, the mainstay of treatment for Depuytren contracture is
surgery with injection procedures also performed. I believe that radiation
has been used as a preventative, but that seems unusual. I have a relative
who underwent Depuytren surgery and he did great. I think the bottom line
is treat early and don't wait.

I hope this helps and all the best,

Z
Depuytren contracture is a hypertophic scarring of and around the flexor tendons in the palm of the hand.

Ultrasound guided injection of collagenase (an enzyme) can dissolve some of the scarring. An oral herb cocktail that can be obtained from Natalia Bragg in Maine will help to heal the lesions and to prevent them from recurring (Knot II Bragg farms)