Hand & Wrist Center of Houston Home If you suspect broken bones, dislocated joints, lacerated tendons, lacerated nerves, infection, or have an open wound below the elbow, then call us immediately.
DUPUYTREN'S


WHAT YOU SHOULD KNOW

Dupuytren's contracture is a special disease that is transmitted genetically from Northern European ancestors. It causes the layer of tissue under the skin but above the tendons and joints to spontaneously contract slowly. Eventually the skin becomes attached and the joints become permanently flexed. No medications, therapy or splints can stop the process. Patients are counseled to follow periodically with an expert in hand surgery until advised that the condition has advanced enough to merit undergoing surgery. Treatment is reasonable to consider when one or more fingers have actually become stuck in a forward bent position that interferes with daily function. .

MEDICAL HISTORY

Patients often cannot even remember the number of years the nodules or cords of tissue have been present in the palm of the hand. They note progressive stiffness, mild pain grasping objects, and eventually loss of function in the hand.

EXAMINATION

The doctor will note each location of involvement including the degree of skin puckering or bonding and the measurement of each joint contracture.

ADDITIONAL TESTS

Plain x-rays will reveal any underlying arthritis in the affected joints that may make achieving good motion more difficult.

TREATMENT OPTIONS

  NO INCISIONS INCISIONS ONLY AS NEEDED
CONSISTS OF Needle used to disrupt contracted cord of tissue Surgical excision of the diseased tissue
FEATURES Abnormal tissue only separated but not removed Extent of incision depends on goals for removal of tissue
ADVANTAGES No incision More complete correction, less recurrence
DISADVANTAGES Less correction, faster recurrence More scar formation and trouble healing the surgical wounds

Using a needle to disrupt the diseased tissue is called "percutaneous aponeurotomy". Some doctors may offer another way to disrupt the diseased tissue, but only at one point with no actual removal of the diseased tissue by injecting a liquid enzyme "collagenase" into the hand. At best it only accomplishes the same as needle aponeurotomy but with several additional risks. The liquid enzyme can disrupt any body structure made out of the molecule collagen which is the main component of tendon, nerve, and skin. Complete tendon rupture has occurred with the use of collagenase injection. Also the manufacturer warns specifically about the need to be fully prepared to resuscitate a patient from anaphylactic shock (which can be fatal) as anaphylaxis could occur from collagenase injection. Since most of these injections would be given in a medical office building rather than a hospital, this may not be the safest practice for patients.

RECOVERY

Sutures are removed after 2 weeks in the office. Outpatient rehabilitation exercises are started immediately to regain motion. Use of the hands for everyday activities is encouraged right from the start. Wound healing issues, pain and swelling are very individual and determine how many weeks after is surgery is really practical for good hand use. Therapy continues for a period of several months until the motion achieved has been maximized. Splints to maintain the straight position are worn at night for up to 4-6 months after surgery.
 
 
 
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  • The entire team at the Hand and Wrist Center is outstanding. They made the recovery so smooth and comforting from the courteous receptionists, excellent occupational therapist, attentive medical assistants, and brilliant doctor. Thank you! - 03/31/17
  • Very happy I came here for the surgery, etc. - 06/09/17
  • We have had the best experience here. The staff has always accommodated us and since Tyler is only 10, they always go out of their way to make sure we are comfortable. I have and will continue to recommend Dr. Henry and his staff to anyone I know. Thanks! - 02/28/17
  • Fabulous I will be recommending to everyone I know that can benefit from the services provided. - 03/14/17
  • all excellent care - 07/12/17
  • thank you, you all were very helpful - 03/03/17
  • thank you for all you have done! I recommend you foranyone that is having any problems via hand wrist. Amazing surgon and doctor!!! - 02/01/17
  • very helpful staff - 01/16/17
  • :) - 06/01/17
  • The doctor was very informative and provided me with a solution quickly and I really appreciate that in this day and age. This is an awesome institution. - 03/02/17
  • Great work. - 02/03/17
  • The staffs here was GREAT!!!! - 06/21/17
  • very good at explaining how I should take care of my thumbs and always answered any question I had regarding my health issue I was very pleased with my visit and the care I got at both visits - 03/07/17
  • FIRST CLASS!!!!!!!!!! - 03/03/17
  • everything HAS BEEN GREAT AND HEALING WELL WITH ALMOST FULL MOTION IN LESS THAN 5 WEEKS. tHANKS dr hENRY - 03/03/17
  • very good team work, best clinic - 06/21/17
  • always outstanding service! - 04/12/17
  • Dr. Henry and Mary in PT helped me get my dominant arm back in working order. - 04/18/17
  • Great staff. - 05/02/17
  • Awesome experience. Luis rocks! - 04/06/17
  • :) - 05/11/17
  • All the staff and Doctor Henry were great! - 05/01/17
  • Staff is always friendly and helpful. I will definitely recommend this office. Dr. Henry is a very skilled surgeon and went out of his way to make sure I understood my procedure and the rehabilitation process. - 03/24/17
  • Great Appoitnment - 05/11/17
  • great service nice folks glad I came to this office doctor was very cool - 03/23/17
  • Staff was very courteous and helpful. Dr. was very informative and easy to understand. - 03/27/17
  • Had a wonderful experience overall. Breaking my arm was tough but the staff here was always very, kind and helpful. Especially Dr. Henry, Mary, Karen, Luis, Joel, Teresa and David. I'll miss them all but hopeful won't have to see them any time soon :)Thank you! - 05/04/17
  • thank you for helping me - 02/03/17
  • some of the most friendly staff and the doctor always explained the information in a manner in which I could understand which always made it very helpful. will definitely recommend this location to family and friends. - 05/31/17
  • Luis was great as well. - 01/04/17
  • Very knowledgeable about the possible procedures the could be preformed! Dr. Henry is a very honest person and I appreciate that in a man more than anything. He gave me truth and not what I wanted to hear! Thanks - 04/04/17
  • Really appreciate the education and insight related to my wrist and future athletic training - 05/31/17
  • Great staff, Great Doctor, Great surgery, recovery, and follow up. Thank you for the time and attention with helping me through the entire process. I felt very comfortable and safe with the entire process. - 02/10/17
  • Very professional - 03/30/17
  • This was my last visit and I'll miss y'all. - 03/29/17
  • Dr. Henry gave me my wrist back!!! Thank you Dr. Henry!!! - 07/10/17
  • Dr. Henry did an excellent job on my grandmothers wrist. Staff is always very friendly and helpful. - 03/02/17
  • very impressed with the whole experience. - 02/28/17
  • excellent! dr & staff! - 06/14/17
  • Thank you for the hard work and excellent care. If ever I need this type of care again I will be knocking on your door. I've already recommended your services to others. Thanks Again! - 03/07/17
  • joel was also my assistant but everything was great - 03/07/17
  • Everyone was kind and efficient. All things were clearly explained to me and I felt confident in doing my dressings. - 03/03/17
  • FIRST CLASS!!!!!!!!!! - 03/03/17
  • I was very impressed with how I was treated by the doctor as well as the Medical assistant. All my questioned were answered and I was treated with care and respect. Luis was Awesome! Doctor Henry was very informative. I will recommend him to friends and family - 06/09/17
  • Doctor Henry was awesome! And Luis was very helpful and nice! - 03/20/17
  • great job! - 03/20/17
  • I have enjoyed this facility and Dr. Henry has been more than helplful. All questions answered, as well as answers I didn't even know I had! The staff is always helpful. - 03/03/17
  • I have loved coming here and felt very welcomed by everyone! Thank you so much for all you do! - 03/10/17
  • Great staff and speedy process! - 04/14/17
  • thank you - 02/09/17
  • Dr Henry is a wonderful Dr. and I would highly recommend to others - 02/07/17
  • Thank you! - 03/08/17
  • Love the Doctor and his staff. - 02/08/17
  • everything HAS BEEN GREAT AND HEALING WELL WITH ALMOST FULL MOTION IN LESS THAN 5 WEEKS. tHANKS dr hENRY - 03/03/17
  • Great Appoitnment - 05/11/17
  • I gained full confidence in Dr. Henry and his staff as I progressed through my recovery. - 03/28/17
  • I feel very confident in Dr Henry and the direction I am headed. - 03/10/17
  • I have enjoyed this facility and Dr. Henry has been more than helplful. All questions answered, as well as answers I didn't even know I had! The staff is always helpful. - 03/03/17










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