Understanding the distinction between Dupuytren’s Contracture vs Trigger Finger is crucial when discussing hand conditions. These ailments present distinct challenges and symptoms, but both can significantly impact hand functionality and comfort. As a physiotherapist specializing in hand conditions, I’ve encountered numerous cases of Trigger Finger and Dupuytren’s Contracture, two common hand disorders that can significantly impact daily life.
Let’s delve into each aspect to comprehend the differences and similarities between Trigger Finger and Dupuytren’s Contracture.
What is Dupuytren’s Contracture vs Trigger Finger ?
Trigger Finger vs Dupuytren’s Contracture encompasses various issues affecting hand mobility. Both of these conditions concerns problems leading to finger locking or n finger bending. Understanding these conditions is vital to identify the root cause and appropriate treatment.
The thickening of a deeper layer of tissue known as the fascia
Thickened tissue contracts, causing the fingers to bend toward the palm
The contracture develops and the finger remains bent
Sometimes patients experience no pain
Trigger finger, also known as tenosynovitis, Inflammation of the tendon
The finger gets stuck in a bent position and may snap or release suddenly when straightening it
Clicking sound when try to straight-finger
Mild pain or slight swelling might be present at the base of the affected finger
Causes & Risk Factor
Determining the causes of Trigger Finger vs Dupuytren’s Contracture involves recognizing different factors. Repeated gripping activities often contribute to Trigger Finger, while Dupuytren’s Contracture is linked to genetic predisposition and is more prevalent in certain ethnic groups.
Sometimes Genetic factor
Risk Factor: Smoking , Alcoholic
Prevalence: Commonly Male
Inflammation leading to swelling of a tendon
Risk Factor: RA , Diabeteis , Inflamamtory disease
Prevalence: Female, individuals over 40 years old
Symptoms of Dupuytren’s Contracture vs Trigger Finger
Recognizing the symptoms of Trigger Finger vs Dupuytren’s Contracture helps differentiate between these conditions. The difference in symptoms in bothr hand condition as follow;
lump or hard spot develops in the palm
bands resembling scars form across the palm
Fingers gradually curve toward the palm
Involve both hands. Pain is less common
The finger getting stuck in a bent position
Clicking sensation when trying to straighten the finger
Symptoms often aggravated in the morning
Pain experienced at the base of the affected finger
Diagnosis of Dupuytren’s Contracture vs Trigger Finger
Diagnosing Trigger Finger vs Dupuytren’s Contracture involves various assessments and tests.
Physical Examination, History
If you find it hard to lay your palm completely flat, it might be a sign of Dupuytren’s Contracture.
Ultrasound examination typically reveals thickening of the A1 pulley positioned over the metacarpal heads
Thickening is usually considered significant when the diameter measures over 1.1 millimeters.
Treatment Options for Trigger Finger vs Dupuytren’s Contracture
Treatment strategies for Trigger Finger vs Dupuytren’s Contracture vary based on severity. Surgical interventions, injection therapies, and enzyme treatments are among the options used to address these conditions, aiming to improve hand function and alleviate discomfort.
Invasive Treatment require
Applying anti-inflammatory gels to the tender area at the base of the finger
Use trigger finger medical devices to straighten the finger – try splinting for approximately 3 weeks
Surgical Treatment options
Surgical treatments are often recommended for Dupuytren’s contracture when certain criteria are met. These criteria typically involve the degree of bending in the affected joints, such as an angle of 30-40° or more at the knuckle joint (metacarpophalangeal joint), or a contracture of 10-20° or more between the smaller joints in a finger.Timely surgery might be suggested, especially if the contracture affects the first joint within the finger, as it becomes more challenging to correct over time.
Open Fasciotomy: Involves cutting the thickened tissue by making an incision in the overlying skin.
Needle Fasciotomy: Also known as needle aponeurotomy or closed fasciotomy. A fine needle is inserted through the skin over the contracture, and the sharp bevel of the needle is used to cut the thickened tissue underneath the skin.
Open Fasciectomy: Involves removing the abnormal thickened tissue completely. Unlike fasciotomy where the tissue is cut, fasciectomy involves complete removal. It’s a more extensive procedure but provides the best chance for a long-term cure. This is the most common surgery for Dupuytren’s contracture, although even with this procedure, there’s a chance of the condition recurring.
The surgical correction of trigger finger is typically done as a day case procedure, meaning you won’t need to stay overnight in the hospital. Normally, you’ll receive a local anesthetic to numb the finger. During the procedure, the surgeon will make a small incision in the palm of your hand. This allows them to access and release the tight band called the A1 pulley, which is constricting the tendon, causing it to get stuck or catch.
This surgery is generally considered low risk; however, like any surgery, there is a recovery period and a possibility of complications
Each surgical method carries some risks, such as potential damage to nearby tendons, blood vessels, and nerves. Infection in the hand is also a possible risk associated with these procedures. The choice of surgery depends on the severity and location of the contracture, and your specialist will advise on the most suitable option for your condition.
Non-Surgical Treatment of Trigger Finger vs Dupuytren’s Contracture
Non-surgical treatment options for Dupuytren’s contracture & trigger finger have expanded beyond traditional surgical methods. These new treatments offer alternatives for individuals in the early stages of the condition and may not be suitable for severe cases. Among these non-surgical options are injection treatment and radiation therapy.
Injection Treatment: A medicine known as collagenase Clostridium histolyticum (Xiapex®) is injected into the thickened area. This medication contains enzymes that can break down the thickened tissues. This procedure doesn’t involve surgery and is performed as an outpatient treatment, typically taking only a few minutes. The following day, some straightening and stretching of the fingers might be conducted, which can cause discomfort.
Radiation Therapy (Radiotherapy): This treatment involves exposing the affected hand to several low doses of radiation. Evidence suggests that radiotherapy can effectively slow the progression of Dupuytren’s contracture in its early stages.
A steroid injection around the affected tendon can significantly help reduce inflammation associated with trigger finger. Statistics suggest that approximately 70-80% (7-8 out of 10) of trigger finger cases show resolution with just one steroid injection. However, for the remaining 20-30% (2-3 out of 10), a second injection might be necessary. It’s important to note that if you’re considering a steroid injection, it’s advisable to review the enclosed leaflet for detailed information about the procedure.
When to visit the Doctor ?
If you’re experiencing symptoms related to Trigger Finger or Dupuytren’s Contracture, seeking medical advice is crucial, especially when these symptoms interfere with your daily activities or hand function. For Trigger Finger, if you notice persistent finger stiffness, popping or clicking sensations, or difficulty straightening or bending your finger, it’s advisable to consult a doctor or a hand specialist. Similarly, for Dupuytren’s Contracture, if you observe the development of lumps or nodules in your palms or experience finger contractures, seek medical attention. Additionally, if your finger movements are restricted or if you’re unable to lay your palm flat on a tabletop, it’s essential to schedule an appointment with a healthcare professional. Early diagnosis and intervention can significantly impact the management and treatment outcomes of both conditions, ensuring the preservation of hand function and quality of life.