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Surgery Advised

When I was about 57 years old, in 1998, I finally complained to my doctor that my little fingers were curled. That is, I could not extend them and make my hand lay flat on the table. He explained that I have Dupuytren's Contracture, a thickening of deep tissue (fascia) which passes from the palm into the fingers. Shortening of this tissue causes "bands" which pull the fingers into the palm. The cause of this is unknown but it tends to run in families and may indicate that I have Viking ancestry! It may be noted that famous sufferers include Ronald Reagan and Margaret Thatcher. The condition is progressive and conventional wisdom is that the only treatment is surgery. If untreated, the fingers will be gradually pulled into the palm.

There are three stages of Dupuytren's contracture, based on the curvature of the fingers:
1 less than 45 degrees
2 between 45 and 90 degrees
3 greater than 90 degrees

My hands were in stage 1, and I was advised to wait for stage 2, then seek out a good hand surgeon. The reason for the delay is that recovery from the surgery is lengthy, with up to 6 months of physical therapy needed. Furthermore, surgery is a treatment, not a cure, the bands usually return, perhaps within a few years. The prospect of two surgeries and two physical therapy periods was daunting.

If you would like more information from a traditional surgical approach, see the University of Virginia web site describing the condition and its treatment. Another good description is provided by The National Institutes of Health at the NIH web site. Dr. Belcher is an English surgeon, his web site provides (somewhat greusome)details of the surgical approach.
Some web sites , such as the bbc web site acknowledge that there are alternatives to surgery



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