Catch-22s of Dupuytrens

The two “Catch-22s” of Dupuytren’s, or why there’s no perfect treatment:

  1. Medical Treatment: Biologically, Dupuytren’s is just like the shrinking and scar formation normally activated as part of the body’s normal wound healing process.  So, any medicine strong enough to stop this process would logically have to also damage the body’s basic ability to heal. A medical treatment will be developed, but it will have to be nontraditional.
  2. Surgical Treatment: The palm of the hand affected by Dupuytren’s behaves as though it is trying to shrink and heal an open skin wound that isn’t there. When surgery leaves skin wounds, because the hand has Dupuytren’s, the normal reaction to wounding can be greatly exaggerated:  swelling, stiffness, tenderness, difficulty using the hand, and this reaction can drag on for much longer  than it would without Dupuytren’s. The reaction to open surgery can result in permanent complications even if surgery is technically perfect.