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mpandy
Trad climber
Jackson Hole, WY
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Topic Author's Original Post - Oct 2, 2007 - 08:16pm PT
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Anyone out there have this on their hands?
If so, how has your experience been? How long have you had it? Progression rate? Eventual treatment, if any?
I'm 38, and look to be just starting this journey.
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Prod
Social climber
Charlevoix, MI
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Hey Mpandy,
I have a older friend who had it a few years back. He is now 70, I have known him since he was 58. His condition came on in his early 60's and he had it operated on when he was 68. I golfed with him 2 days prior to the operation. I think he had to take a long (3 months) break afterwards. Other than that I do not know too much. Send me an email if you want me to get more info from him.
Good luck,
Guy
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rradakovits
climber
san diego
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I'm not a doctor and so far I don't have any signs of Dupuytrens (I'm 31), however, both my sister and father has it.
My dad has had it for many years, he's 68 and has had the surgery 2 or 3 times during the last 20 years or so. The surgery has worked pretty well for him, no complications and pretty decent finger dexterity, he's still active in martial arts (iaido and jodo) but I know that the surgery has some risks, including possible nerve injuries.
I met an older climber at Mt Woodson who also suffers from Dupuytrens, he told me about an alternative way of treating Dupuytrens that he claims is prefferable since it is much less invasive, costs less, has less risk of complications and allows you to return to activity much faster.
The method is called Needle Aponeurotomy, check out www.handcenter.org for more information.
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rradakovits
climber
san diego
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Forgot to mention that I've heard that the outcome is best if you get treatment sooner rather than later.
With both Needle aponeurotomy and surgery it seems that you may have to repeat the procedure every 5-10 years.
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David Nelson
climber
San Francisco
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I am a hand surgeon and a climber (jugged up the Nose and HD behind Ken Yager, known on this list as Chicken Skinner). I also treat Dupuytren's and have it in both hands.
You can learn more about Duputyren's in an essay I wrote, here: http://www.davidlnelson.md/Dupuytrens.htm
The website you refer to, handcenter.org, is the website of my friend, Charlie Eaton. (I know him fairly well, nominated him to join me on the Board of the Internet Society for Orthopedic Surgery and Trauma). He is the main proponent for needle aponeurotomy in the US.
Proceed carefully, read between the lines, and study the literature before you start equating needle aponeurotomy with open fasciectomy (the standard procedure). On my webpage, you can read about the standard care, needle aponeurotomy, as well as bacterial collagenase, which is an enzyme that is injected and dissolves the cords. There is a reason it has taken years to get through the FDA. I had dinner last week with the lead investigator for the enzyme, proceed slowly. It is still investigational.
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slobmonster
Trad climber
berkeley, ca
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I have three contractures, two in my left hand, one in my right.
I'm 32, and these have been present for ~8 years. Only the right pinkie has a "permanent" bend, and won't flatten out.
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Ghost
climber
A long way from where I started
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It hit me about 15 years ago at around age 45. First in the pinky of my left hand, then a few years later in the pinky of my right. I just climbed a lot, and did (and still do) a ton of stretching of the affected fingers backwards. That seems to have done the trick for me.
It also hit my then wife at about the same time. She had surgery, which worked for her.
No idea what will work for you. Sit down with a good hand surgeion and talk about it. Maybe David Nelson's website would be a good place to start.
D
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Mungeclimber
Trad climber
sorry, just posting out loud.
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gnar surgical pic on the site.
stretching now, even if I don't have it.
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mpandy
Trad climber
Jackson Hole, WY
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Topic Author's Reply - Oct 3, 2007 - 06:54pm PT
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Thanks to everyone for sharing their stories. It is encouraging to see that it can be managed.
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Brian Hench
Trad climber
Anaheim, CA
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Oct 14, 2009 - 12:17pm PT
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I just wanted to update folks on the status of Dupuytren's Contracture treatment research. There is a treatment that is similar to needle fasciotomy, but less invasive, that uses an enzyme collagenase to break up the scar tissue that causes Dupuytren's.
The company Auxilium has licensed its collagenase product to another company, Biospecifics Technology Corp. under the trade name of Xiaflex. Phase III clinical trials have been completed and the data has been submitted to the FDA as a BLA, the equivelent to an NDA for biologics.
http://www.dupuytren-online.info/dupuytren_collagenase.html
http://www.auxilium.com/ProductPipeline/DuputrensContracture.aspx
http://www.biospecifics.com/pipeline/
I am afflicted in the early stages. There is not significant contracture in my case but rather bothersome nodules that become irritated under certain conditions. It may be borlderline off-label use in my case, but I am interested nonetheless.
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Roman
Trad climber
Bostonia
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Oct 14, 2009 - 12:36pm PT
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I did not know what this was so I looked it up. It looks to be caused by ill-behaved palmar facia. All I can say is that I hope to god its not as painful as inflamed plantar facia and I hope you get well soon. Looks to be quite treatable though. Best of luck.
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Brian Hench
Trad climber
Anaheim, CA
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Oct 14, 2009 - 12:47pm PT
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For most people it's not painful, but as it progresses it begins to limit extension of the fingers. This could be a problem for a crack climber.
What it comes down to is deciding when the inconvenience of the condition exceeds the trauma of the treatment. I'm hoping that this less invasive treatment becomes generally available by the time I need it.
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ydpl8s
Trad climber
Santa Monica, California
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Oct 14, 2009 - 12:50pm PT
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I'm 55 and mine came on about 2 years ago. First my left hand with nodules below the 3rd finger and then the cord below sticking out and the "hole" above the nodules. I've got just a minor bit of lack of range on that hand. About 6mnths later, 2 nodules showed up on my right hand below the 2nd and 3rd finger, with a cord and hole on the 2nd finger. At the same time I developed a similar nodule on the arch of my right foot.
The doctor told me to stay away from surgical procedures until the range of motion made it imperative. He said that often when you have surgery, it comes back worse than before. He also said that stretching made it worse in the long run....what gives? This seems to disagree with some of the stuff written here. I am currently just appying vitamin E cream liberally daily. I've sort of convinced myself that it is slowing down the onset, but I may just be fooling myself. I'm mostly afraid it is going to screw up my guitar playing.
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FeelioBabar
climber
Just leaving your mom's house...what a gal.
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Oct 14, 2009 - 12:54pm PT
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Cool thread! My father and grandfather have suffered from this...so I imagine I will also given time, though at 35...no signs yet.
One thing I find interesting about it, is "they" say it's positive proof of a Viking lineage.
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Brian Hench
Trad climber
Anaheim, CA
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Jan 11, 2010 - 04:50pm PT
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My sister is 4 years younger than I and doesn't climb. She and I were hanging out with my brother, who is a doctor. She shows him this lump on her palm and asked him what it was. Dupuytren's! Looks like we have a genetic link here. I thought it was supposed to be much less common in women though.
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Jaybro
Social climber
Wolf City, Wyoming
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Jan 11, 2010 - 05:23pm PT
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I wonder if that's what's going on with my hand?
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Jimmy S
climber
Granite State
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Jan 11, 2010 - 06:34pm PT
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Thanks for starting this thread mpandy, I wanted to do the same. I first noticed this in my hands in 1992. Although it freaked me out at the time, I have continued to climb with out too much distraction. I got a cortisone shot to try to break it up. That didn't seem to help much. I have it on three fingers. In the last year my "good" hand has started to hurt more and more. Seems to be growing faster than the others right now. I know two climbers that also have it. They are in their 50's. One doesn't notice it too much. One had the surgery, got nerve damage and lost feeling in his finger, or was it hand?, for over a year. So far I pretty much stretch it and deal. Very curious to hear from other climbers that are perhaps further into it.
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chez
Social climber
chicago ill
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slobmonster.
Thats nothing compared to what i have, what you have shouldn't slow you down a bit. I will have to post some pics later. I was at your stage more than a year ago.
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slobmonster
Trad climber
OAK (nee NH)
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It's been well over a year, and my Dupuytrens Contracture (aka "Viking's Disease") has progressed significantly. So this morning my hand was injected (more like jabbed repeatedly) with Xiaflex
http://en.wikipedia.org/wiki/Xiaflex
into the little finger and ring finger of my Right hand.
This is what my hand looked like a few hours ago:
Right now those little swollen piggies are even phatter, and man do they feel weird. Tomorrow the doc will yank my fingers, probably somewhat violently, and break up all that dissolved collagen. After that I get a splint for 2 weeks or so. Best case scenario: my fingers are straight. Worst case: they are not.
Will update with video of finger yanking procedure if I can convince the office assistant to film.
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Ghost
climber
A long way from where I started
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Tomorrow the doc will yank my fingers,
You're just setting that doctor up for one of those "pull my finger" fart jokes, right?
But seriously, good luck.
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donini
Trad climber
Ouray, Colorado
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Yup....srarted about the same time as you and I'm now 68. Only surgery I've ever had was on my left hand when the little finger started to interfere with crack climbing-I was climbing again 10 days after surgery.
Still have a bit on the right hand that has bent my little finger in, but progression has stopped and I haven't done anything.
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slobmonster
Trad climber
OAK (nee NH)
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This morning, my doc (Lamont Cardon MD, in Berkeley CA) gave my fingers the dreaded yank. Wow. Now THAT made an uncomfortable noise. (Video to follow, when I receive it.)
Anyway, here are the results:
Little and ring finger are now, for the most part, straight. A little swollen and with some edema, but hey, that one little piggie ain't crooked permanently at 70°.
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slobmonster
Trad climber
OAK (nee NH)
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For future reference, and also b/c I know many climbers with this issue...
Before:
And After:
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mucci
Trad climber
The pitch of Bagalaar above you
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Glad to see that worked slob..
Of all of the hand/wrist ailments I have, thankfully this is not one of them.
Good luck to those afflicted. Looks like big wall crab hands.
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chez
Social climber
chicago ill
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Mar 18, 2012 - 04:26pm PT
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Slob,
Good job, looks like your finger didn't crack, mine did. I got mine done the same day here in Mammoth. I did not hear the dreaded POP!
The anesthetic injection hurt the most. I ended up kicking the Surgeon on accident.
He replied " Don't kick the guy with the needle in his hands".
Still rehabing doing stretches and back to work in a few days.
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chez
Social climber
chicago ill
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Mar 18, 2012 - 04:41pm PT
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[photoid=241351]
couple of shots, before and after.
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chez
Social climber
chicago ill
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Mar 18, 2012 - 04:43pm PT
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Mungeclimber
Trad climber
sorry, just posting out loud.
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Mar 18, 2012 - 06:36pm PT
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huh, my right hand pinky seems to be perpetually slightly bent. wonder if I have this to look forward to.
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Fish Finder
Social climber
THE BOTTOM OF MY HEART
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Mar 21, 2012 - 11:48am PT
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Way to go chaz,
its good to see you are straightening things out .
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darkmagus
Mountain climber
San Jose, CA
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Mar 21, 2012 - 12:41pm PT
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Hi everyone, this is my first post here! I'm a chiropractor and rock climber, and wanted to add to the already excellent information contained within this thread. I wanted to mention Graston Technique as a possible treatment option. It's an 'instrument assisted soft tissue technique" which can be used for a variety of conditions in which adhesions are present. It should be pretty easy to find information about it online. There isn't any specific literature relating this particular treatment with dupuytren's contracture (that I know of), but may be worth looking into as an option before committing to the surgery. Hope that helps, and good luck!
-Dr. Michael Lagueux II, D.C.
Positive Edge Chiropractic
San Diego, CA
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darkmagus
Mountain climber
San Jose, CA
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Mar 21, 2012 - 12:44pm PT
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Oh man, looks like I showed up way too late to this thread! Glad to see you're doing well!!
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Fish Finder
Social climber
THE BOTTOM OF MY HEART
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Mar 21, 2012 - 12:50pm PT
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Welcome darkmagus,
Its always great when professionals share their knowledge here .
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slobmonster
Trad climber
OAK (nee NH)
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Hey all. My doc just sent me a VIDEO of my manipulation after being injected with Xiaflex. Not really all that traumatic, but if you listen carefully you'll hear the crack/rip.
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Chaz
Trad climber
greater Boss Angeles area
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May 26, 2012 - 02:17pm PT
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I was hanging out with the family yesterday ( my aunt and two ( four? Maria is heavy with twins ) cousins went to Joshua Tree - screaming nice weather - got some bouldering in, and even got the kite in the air )
Aerial TR:
http://www.flickr.com/photos/30901290@N03/7274342810/in/photostream
http://www.flickr.com/photos/30901290@N03/7274322546/in/photostream/
http://www.flickr.com/photos/30901290@N03/7274244116/in/photostream/
We're on our way home when Maria asks me "Do you have pain running down the middle of your hand?"
"How on earth did you know that? I've never mentioned that to anybody". Right out of the blue she asks me about the one ( minor as it is - at present ) physical challenge I'm occasionally dealing with.
It just cropped up in the last year or so. ( I'm 49 ) I wrote it off to use-and-abuse, climbing, work, etc.
It runs in the family. My dad and one of my uncles have it. None of the females - at least right now.
My uncle told me his information said the problem is hereditary, and could be traced back to a small population in Eastern Europe.
My uncle couldn't remember the name of it - which is good, because I couldn't have remembered it if he had told me. He suggested I look around for some sort of "trigger finger" affliction.
The info I found says Dupuytrens came from Scandanavia - not Eastern Europe. And I'm not sure how small the original pool of afflicted was.
The BEST info I've found, however, has been right here, on Supertopo. Reading everyone's accounts, and what the Pros are saying, gives me better idea of what's going on.
Good luck to everyone living with this.
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Crimpergirl
Sport climber
Boulder, Colorado!
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May 26, 2012 - 04:43pm PT
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Interesting info. Hope your hand stays healthy!
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storer
Trad climber
Golden, Colorado
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Jun 18, 2012 - 09:32pm PT
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I have it in my pinky, right hand, although I'm left handed. Said to be genetically disposed as the only risk factor (ok, guilty here, alcohol). But I had my share of face climbs, rubber donut squeezes and general abuse of the guns. So I have my theories too.
So at age 68, like Donini, I couldn't flatten my hand on the rock let alone shake hands without attemping to disguise it with a secret handshake.
I opted for the needling treatment; a small needle with local numbing is used to sever the cord at two places, on the palm and in the first joint, said to be less intrusive and less downtime. I too heard the pop as the cord broke ( the "release") but the skin broke too. I wish the doc had just switched to the radical zig- zag cut and pulled that sucker (the cord) out because two years later it's back at 90 degrees again and the scar tissue on the palm and first joint hurt.
So after my bike ride in August I'm going back to the first doc who told me all this and getting the radical, zig-zag, cut. Gotta admit, I'm an old retro-grouch and doubt that a $3800 per shot, up to three required, on Medicare is to my liking. But I am happy to hear that some of you are happy to be climbing again as I hope to be.
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bahboric
climber
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I have Dupuytrens and am trying to decide between surgery and the Xiaflex injection; my insurance will cover either, so the cost is not an issue. Through google I see that with Xiaflex a possible side effect is a ruptured tendon. Since we climbers put a lot of stress on our hand, I was wondering if anyone had information about whether Xiaflex is, or is not, recommended for climbers. The Xiaflex seems to have a much quicker recover, which is nice, but I don't want to end up with an even more serious problem than Dupuytrens. Thanks.
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slobmonster
Trad climber
OAK (nee NH)
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Wow. Crazy timing. I've actually been meaning to find this thread again and add a comment.
So. I had my Xiaflex injection + procedure in March 2012. It's now, what, like 18 months later? Although not as bad as it was before, the contracture in my R pinkie has come back. Not as weird/"painful" as before, and not as bad, but it's back. Just FYI.
If you have the time (for recovery), your insurance covers it, etc., you may do well to consider the surgical option. (Ask your Dr. though!)
(And tell us what s/he says!)
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Gimp
Trad climber
Grand Junction
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Small finger often does poorly no matter the treatment.
So you might have went through a longer recovery and still be at the same point.
Truth be told with Dupuytrens if you live long enough it will probably come back.
I tell all my patients (and working at a VA rarely a week goes by I don't treat the disease in one manner or another) no matter what treatment we decide on that the disease can hopefully be managed not cured.
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chez
Social climber
chicago ill
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Mine has not come back at all.
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bahboric
climber
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After your Xiaflex injection, how long was it before you were able to climb again? Was returning to climbing dependent on it being too painful, or some other problem that might arise if one climbed too soon?
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storer
Trad climber
Golden, Colorado
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It seems like there are 3 treatments; Xiaflex, needling, and zig-zag cut. I've had the latter 2 on my right hand. Needling tried first. Popped the cord but popped the skin too leaving scar tissue which still rendered a bent pinky. Better but not straight. My doc said that would happen but I did it anyway with a different, second, one. I went back to the first doc who only does zig-zag. Beautiful job. Pinky bent slightly because of that original scar but clean result on palm.
Next week, left hand with the first zig-zag-only doc. I like the idea of yanking that bad sh*t out of there and trash-canning it.
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bahboric
climber
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So after the zig-zag treatment, how long before you were able to climb?
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Roots
Mountain climber
Tustin, CA
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Thought I would post up here, but I recall another thread floating around...anyways:
Had the contracture since I was about 25. Over the past 24 years it contracted more. It finally became an issue a couple years ago when I couldn't get my hand in most cracks without the use of my other reaching over to flatten the right so it would slide in.
I have it on both hands, but the right was the worst. The left can wait for a few years (I hope).
It is hereditary, my father had it too. Vikings, English and Scots appear to be the most common lineage.
Had surgery last week. The shot would not have worked for me.
Here are the pics:
The splint is to keep me from moving the affected area and to train my hand to be flat. Fingers have been bent for so long that this is necessary.
Stitches out this Monday (10 days after). Then I have to start some mild rehab. Should be climbing by end of the month (30 days). Although doctor said I could climb this Tuesday, it's obvious to him and myself that I need more time. Too much swelling....
No pain at all.
Hope that helps whoever is next : )
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donini
Trad climber
Ouray, Colorado
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The little finger of my left hand was canted in to the point where it interfered with crack climbing. I had the zig zag surgery about ten years ago.....it cleared up completely and has stayed that way.
I started climbing again, albeit very carefully, before I had the stitches removed. My right hand has the same problem but the little finger has stabilized and has not canted in far enough to cause a problem with my climbing so I have done nothing for it.
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NutAgain!
Trad climber
South Pasadena, CA
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Thanks for the heads up on this... I have noticed a lack of flexibility in my hands that often leads me to stretch them out. My grandma had a fairly severe form of something like this, and whenever someone did or said something that annoyed her, she would say "want to see my operation?" and then flip 'em the bird with her pinky and ring finger all curled up.
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Todd Bauck
Trad climber
Denver, co
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Jan 20, 2018 - 04:42pm PT
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I had the needle aponeurotomy done and was very pleased with the results. It took about a half an hour which includes cleaning, numbing, and the actual procedure. 4 days after the operation I was climbing with a small bandage. 2 days after that, I was not even wearing the bandage.
There was no loss of strength. The finger is straight now and I can jam tight hand cracks.
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KathiTheia
Sport climber
Vienna, Austria
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Apr 24, 2018 - 07:57am PT
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Hi, my friend is suffering from Dupuytren since about 3-5 years. He didn't pay much attention to it because it wasn't really painful. Since the last few weeks it became much more painful and disturbs him while climbing.
Can anyone tell us how long after surgery / fasciotomy or xiaflex injection he had to take a break? Did you regain the same fitness in climbing after the procedure?
Thanks a lot,
Kathi
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