Genetic Little Finger Problem

[LoiS-sez]

In prowling the Ergonomics forum I see the pinky or little finger has often been discussed, but not to the extent that might help some people with a very specific condition. My problem was first treated as Trigger Finger, but the therapist noticed it didn't match that condition and wasn't responding to treatment for Trigger Finger. She was familiar with a genetic condition called Dupuytren's Contracture and suggested I see a doctor to be evaluated. Yup, that's what I have. I need to go back over the Locked Little Finger discussion and contact the person who said his little finger tended to lock in a curl. Perhaps he's in the early stages of either Trigger Finger or Dupuytren's Contracture since he said he was able to flick it free. I can't do that.

 

Dupuytren's Contracture comes on slowly, bending the pinky and sometimes the ring finger so that it can't be straightened. Currently there are 3 different treatments. I tried the least invasive.

1. Needle aponeurotomy had my hand numbed and a hypodermic needle tried to divide the diseased tissue. At first it seemed successful. Perhaps I didn't exercise enough afterwards, but I'm inclined to believe the splint I was supposed to wear while asleep was the problem. It was too large and my finger would slip out of it.
2. Another is collagen injections into the damaged tissue and then manually straighten it. Seems to me like the same problem might occur.
3. Surgery can remove the tissue in the palm affected by the disease. This gives a more complete joint release than the other two methods, but may require therapy and takes longer to recover.

Don't know if this information will help anyone, but I know of a fellow storyteller/puppeteer with this condition. Both of us are inclined just to adapt if at all possible.

 

[Dirge]

I've had that for ages; on my middle finger on the LH and third finger on the RH. It never resulted in lost strength, but I can imagine if it is getting bad it cuts your reach and that's where you'd notice it most on your little finger; with me it is not pretty but no problem as yet, but read on...

 

A local doctor told me the gene came down from Viking ancestors. I don't really sunburn despite the hole in the ozone layer down here and this has also been suggested as implying Viking blood so it must be true. It has crossed my mind before now that a large axe would save time and nuisance in certain circumstances, but I think that's just a standard reaction to modern life.

 

Baron Dupuytren was famous in his day for treating Napoleon's piles, now his name is attached to this tiresome thing. Fame was out to get him.

 

I tried to suggest to friends that the marks on my palms were stigmata, proof of my pure and simple lifestyle, but they didn't swallow it.

 

There is a strictly owner's risk fourth treatment option. I went to see the quack and he named it (so he was happy). He said surgery was not certain and sometimes made it worse, which really put me off that one. Time passed and the fingers started to annoy me with their pathetic failure to get into line like they should, so one day I sat at a table and forced them back beyond where they belonged. Flesh tore inside my hand; it was a bit unpleasant but I gritted my teeth and shoved harder against the table until they 'conformed'.

 

This must be 2 or 3 years ago now and the left hand quickly settled vastly improved and has played ball ever since. Complete cure bar a lumpy palm, at least so far. The RH kept trying to revert, so, having started down this trail, I forced it again, and again. It was still unpleasant. The finger and I have now drawn back from open war and reached a sort of N and S Korea type understanding. I leave it alone more than I used to and it doesn't seem to be getting noticeably worse. So that's one success and a partial success. Not bad overall. It worked for me.

 

I have no idea what I risked doing this, AND DO NOT WANT TO KNOW thank you. Ignorance is bliss. But if you feel brutal enough to try it don't come blaming me if you destroy your finger completely.

[Geoff Wooff]

A very long term friend of mine ,who has this Dupuytren's syndrome and also a concertina player, was telling me all about these various treatments.... he's in the medical profession . I would say his case is quite advanced, well it looks pretty scary to me, but he is still playing both diatonic accordion and concertina.

 

My main point is that my friend did quite a bit of research into the various treatments after having one operation , where they scrape the growth from the Tendons ... sounds horrible... but anyway he made some very positive choices about what his next move would be, which treatment was deemed to be the most successfull. I recall he suggested that there were not more than two or three doctors ,in the world, that could perform, or offer to, the operation he was contemplating.

 

If anyone is interested I can try to get my friend to tell us what his findings are.

Edited October 2, 2013 by Geoff Wooff

[Dirge]

If anyone is interested I can try to get my friend to tell us what his findings are.

Well there's Lois and there ought to be me although having gained some ground with my alternative medicine technique I try to ignore it... I ought to be interested though because I expect it to be back. Go on then, I'm interested too.

[LoiS-sez]

Geoff, I'm interested. A local hospital claims they can do the surgery and my husband's after me to see the surgeon who did his elbow and knee replacement. Saying there's only 2 or 3 doctors in the world able to correct it could be a way of saying I'll live with it.

 

Dirge, call me chicken, but I'd like somebody to give me a local anesthetic before trying your method. Better yet anesthetize me and then somebody else whack it into position. Didn't know I had any Vikings in my genetic makeup, must have been invaders to the Celtic Isles on my mother's side. Nothing like a delayed genetic present. Why didn't they just make me blonde?

[Geoff Wooff]

OK, I'll see what I can do. My friend has now retired from doctoring , so's he can spend more time playing music...... I'll drop him a line and hopefully he can help.

 

I do feel some empathy in this area as I have also lost some control of my left little finger (and the third too) after a Stroke... but it has been twelve months since and although things have improved in all other departments I am still left with some difficulties at this extremity.

On the EC I can get around the problem most of the time. On the Maccann it présents more problems as the little finger is used to cover two rows of buttons...

Edited October 3, 2013 by Geoff Wooff

[alex_holden]

Hiya! I've been lurking here for a while but this is my first post. I mentioned this topic to a friend of mine who isn't a member of the forum, and she asked me to post this response on her behalf:

 

 

 

I'm both a concertina player and a trustee of the British Dupuytren's Society.

Needle aponeurotomy is a good treatment, but it will only be effective for 2-3 years before you're back where you started.

Collagenase is slightly more invasive and can cause some painful short term reactions (some anecdotal reports of other problems). The benefits can last upto 5 years before your finger is badly bent again.

Surgery is the most invasive treatment (and will mean that you can't play the concertina for several months). The effects are likely to be longer lasting than NA or collagenase, but the more invasive the treatment, the more likely that Dupuytren's will spread to another finger.

Snapping the cords manually as one poster did is essentially a DIY needle aponeurotomy. (Dupuytren's is a growth around your tendons and both techniques break the cord.) I'm not sure that I'd recommend it, but there is an interesting historical precedent where a saint trod on a woman's fingers and cured her Dupuytren's.

Splints aren't terribly useful. The studies I've seen suggest that wearing a splint won't make much difference to the outcome of a treatment.

There are plenty of surgeons who treat Dupuytren's. See the British Dupuytren's Society for lots of information about different treatments - dupuytrens-society.org.uk

The basic thing to understand about Dupuytren's is that it always comes back. You choose how invasive a treatment you want and trade that against cost and how long it helps for. Remember that you can still have surgery after less invasive treatments, but there is a limit to how many times you can have surgery (due to scar tissue).

Judith

 

 

[Bill N]

I've just had a consultation with a plastic surgeon, who made the same points as Judith's post above. In addition, he mentioned that radiation therapy is sometimes used. in my case, because I am relatively young (early 50's- his words, not mine!) and because the disease has not yet caused me any lack of utility, he has recommended watchful waiting. As long as I can place my hand flat, palm side down, on a flat surface we'll leave well enough alone. In addition to the issue of reoccurance, he also cited a lack of data on long-term complications of some of the treatments, and said that new and better treatments are in the works.

Edited October 5, 2013 by Bill N

[LoiS-sez]

Sounds like "watchful waiting" is in order until it's just to much to handle. Guess those of us with it need to stay in the loop to learn when these "new and better treatments" are available. My husband just doesn't understand why I'm not eager to meet his surgeon.