Dupuytren's Contracture

Bob Branstetter · #1 11-01-2006, 10:17 AM

I have surgery scheduled in early January for Dupuytren's Contracture on my right hand. I am not looking for sympathy, but rather I hope to hear from other bass players who have had Dermofasciectomy surgery for Dupuytren's. (I was going to put in a link for Dermofasciectomy, but the photos are not too pleasant to look at.)

While I have confidence in the surgeon, I know from past experience that almost all surgeons tend to give you the best case scenario when it comes to recovery. I've been told that I can go back to work in 3-6 weeks, but "work" and being a bassist are not quite the same thing. If anyone here has had this surgery or is close to someone who has had of this type of surgery, I would very much like to hear from them. Although the fingers involved (the ring and little finger of the right hand) are not directly involved with playing, I do worry about possible side effects such as nerve damage, muscle tone and other problems that can happen with any surgery involving tissue removal and full thickness skin grafts.

arnoldschnitzer · #2 11-02-2006, 06:44 AM

Bob, I don't know anything about your condition other than what I just read on the link. Wow, that's a serious thing, especially for a musician/luthier. I wish you the best of luck with your surgery and rehabilitation.

christ andronis · #3 11-02-2006, 09:39 AM

Bob, first, best of luck with your surgery and recuperation. From what I've read you should not be hindered by this after a time. In any case, best wishes.

Second, many thanks for hipping me to this condition. For the past 6 months or so I've developed a lump under the skin of my palm consistent with where it shows on the diagram. This is the same hand I had carpal tunnel surgery on about two years ago so I don't relish the thought of any more cutting. I've ignored it as it doesn't seem to have affected my playing at all but now I think I will check it out during my next doctor visit.

Again, best of luck to you and also thanks again for making me aware.

Bob Branstetter · #4 11-02-2006, 11:03 AM

Quote:

Originally Posted by christ andronis

Bob, first, best of luck with your surgery and recuperation. From what I've read you should not be hindered by this after a time. In any case, best wishes.

Thank You. One of the main reasons I chose to have this type of surgery as opposed to the conventional limited faciectomy is that statistically, the rate of recurrance is said to be about 8%. 45-50% recurrence is typical for conventional surgery without the full thickness skin grafts. Since there is no cure for this disease, I like those odds a lot better.

I suggest that you see a hand specialist right away. If caught in the early stages, injections of Aristocort can soften and flatten the nodules. I'm having this done on my left hand now which is in a much earlier stage of the disease than my right hand.

I was very fortunate to learn that one of the leading surgeons specializing in the treatment of Dupuytren's Contracture is located close to my home. His website has more details on the disease and how he approaches the disease. If you do an internet search, you can probably find the doctors in your area who specialize in treating Dupuytren's.

Jake deVilliers · #5 11-02-2006, 02:05 PM

Yikes!

Here's hoping for a full and speedy recovery, Bob.

Good wishes, Jake

Bob Branstetter · #6 11-02-2006, 02:43 PM

Thanks for the encouragment guys. I'm glad that I was able to inform some you who had not heard of the disease. I hope that one or more of you may know someone who has been through this surgery and who is a bass player.

I found out about having the disease by accident. I went to one of the leading orthropedic medical groups in Kansas City for what I thought was a simple cyst on the side of my ring finger. The surgeon scheduled surgery for about 6 weeks later. On the day of the surgery, I was in the prep room at the hospital when the surgeon came in for the usual presurgery pep talk. He took one look at my hand and said "somthing has changed" noteing the change to my little finger and my palm. This all occurred in 6 weeks. He quickly determined that it was in fact Dupuytren's Contracture and not a cyst. He sugested the conventional treatment which is to do nothing until the contracture has reached 30 degrees. I really didn't think much about it for nearly 2 years since it had not reached 30 degrees yet. When my contracture approched the 30 degree mark I started doing research and found out about the other methods of treating the disease. I know now that if I had gone to the doctor I'm going to now, I might not have need any surgery at all. It is a very strange disease in that it progresses in spurts. Mine did a spurt for about 2 months and then for the most part went into remission for a year or more.
I am mentioning all of this so that if anyone else has symtoms remotely like those of Dupuytren's, Don't go to your regular doctor - find a hand specialist and maybe even to another to get a second opinion. It really isn't something that your family doctor is going to know much about.

Bob Branstetter · #7 01-03-2007, 12:44 AM

i had the surgery yesterday and it went well. i probably will not be posting much for a while. i'm not very good at left handed typing. best wishes to all at talkbass.

Jake deVilliers · #8 01-03-2007, 01:40 AM

Get well soon Bob.

I'm sure you'll make a speedy recovery and be back here 'setting us straight' pretty quickly!

Uncletoad · #9 01-03-2007, 02:58 AM

Ouch.

All the best.

Keep us informed of your progress when you can.

**Chris Fitzgerald** · #10 01-03-2007, 07:21 AM

Hang in there Bob - that's scary stuff. Let us know how it's going when you can type again.

JeffKissell · #11 01-06-2007, 01:27 AM

Bob,
I hope yours is a complete and speedy recovery!!
-J

Eric Rene Roy · #12 01-06-2007, 02:27 PM

Bob, my dad had Dupuytren's Contracture. Is the incision from your surgery a straight cut or a zig-zag? I have heard of better results with the zig-zag approach...for lack of better terminology.

May dad had two surgeries...both straight cuts, and they did not correct things. He had it on both pinkies as well as his little toes!

Sorry to be a downer! You know I wish you well!!!

Bob Branstetter · #13 01-06-2007, 05:34 PM

Quote:

Originally Posted by eroy

Bob, my dad had Dupuytren's Contracture. Is the incision from your surgery a straight cut or a zig-zag?

Actually neither. Apparently your dad had the traditional fasciectomy surgery. I had what is known as Dermofasciectomy. It isn't performed by very many surgeons because it is really in the realm of plastic surgery. My surgeon, Dr. Lynn Ketchum, was a well known plastic surgeon before he became interested in Dupuytren's. With Dermofasciectomy, the diseased tissue is removed and replaced by full thickness skin grafts from the upper arm. Here is a link with some details. The recurrence rate with Dermofasciectomy is said to be about 8%. The recurrence rate with traditional surgery is 40% or more. I just hope I am in the 92% who do not have a recurrence.

Bob Branstetter · #14 01-19-2007, 12:22 PM

For anyone interested, I will be documenting my recovery process on the Dupuytren's Forum Website

This is one of the most informative sites I've found for current information about Dupuytren's Contracture disease.

mpm · #15 01-19-2007, 02:50 PM

Best wishes Bob.

wateroftyne · #16 02-09-2007, 10:44 AM

Hi folks

I've just been diagnosed with this at the age of 34. It's very early days yet - as I just have the knot in the palm of my hand - and at the moment I have no other symptoms.

I'm hoping this develops slowly!

Bob Branstetter · #17 02-09-2007, 12:13 PM

Quote:

Originally Posted by wateroftyne

Hi folks

I've just been diagnosed with this at the age of 34. It's very early days yet - as I just have the knot in the palm of my hand - and at the moment I have no other symptoms.

I'm hoping this develops slowly!

NOW is the time to do something about it - before it develops to the point were surgery is the only option. Triamcinolone injections can keep the nodules from hardening to the point that contraction begins. Find a hand surgeon - preferably not one that is part of an orthopedic group. Traditional treatment (which most orthopedic trained surgeon in the US perform) is to do nothing until the contracture has progressed to the point where the fingers are bent to more than 30 degrees. If this is what the surgeon tells you - keep looking. There are some new drugs that have been in clinical trials that show great promise. Unfortunately they have not reached the point where they are available to the general population. I have had Triamcinolone injections in my left hand and they softened the nodules considerably. My surgeon, Dr. Lynn Ketchum, recently discovered that he had developed early Dupuytren's himself. He immediately injected the nodule his hand with Triamcinolone. If you have any questions about Dupuytren's or any of the available treatments, please email me. I've done a lot of research and I think I can offer some helpful advise. Good Luck.

wateroftyne · #18 02-09-2007, 12:35 PM

Hi Bob

Thanks for the advice. I really appreciate it.

I'm going to do everything I can to get this sorted sooner rather than later. I suspect it'll be tricky here in the UK, but I'm going to try. Thanks again.

Bob Branstetter · #19 02-09-2007, 01:36 PM

Quote:

Originally Posted by wateroftyne

Hi Bob

Thanks for the advice. I really appreciate it.

I'm going to do everything I can to get this sorted sooner rather than later. I suspect it'll be tricky here in the UK, but I'm going to try. Thanks again.

I wouldn't be too pessimistic about finding help in the UK. A lot of the research done on Dupuytren's has come from the UK and Europe. Here is a Dupuytren's Forum that is based in Europe. Right now, all they want to talk about is Needle Aponevrotomy (NA), but if you spend a little time searching, you should find some info that will help you. You might even find someone close to you that can give first hand advice.

christ andronis · #20 10-14-2007, 07:45 PM

Bob...it's now October. Status report on your hand?? I'm going to a physical therapist I met on the gig last weekend to have her work on my hand and am in the process of seeing a specialist this week if I can get in.