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Dupuytren's Contracture
Dr. Laura Tharp, an Orthopedic Surgeon Fellowship Trained in hand feet, and elbows, joins us today to discuss Dupuytren's Contracture. A genetic condition that is very common in rural Coffee County.
Featured Speaker:
Laura Tharp, M.D.
A Native of Fitzgerald, Georgia, Dr. Laura Tharp graduated from the Mercer University School of Medicine before completing her orthopedic residency at the Medical University of South Carolina. She then continued to the University of Miami where her fellowship training was in hand & upper extremities. Transcription:
Dupuytren's Contracture
Vicki Lewis: Welcome to Discussions with the Doc. This is a healthcare podcast brought to you by Coffee Regional Medical Center in Douglas, Georgia, where our mission is to provide exceptional care and wellness close to home. Join us as we learn more about rural healthcare in south.
Caitlin Whyte: Welcome back to another episode of Discussions with the Doc. Today, we are discussing a common hand condition found around Coffee County, dupuytren's contracture, and we are joined today by Dr. Laura Tharp, an orthopedic surgeon fellowship trained in hands, wrists and elbows. Thanks Doctor for joining the podcast.
Laura Tharp, M.D.: I thank you for having me. I'm glad to be here.
Caitlin Whyte: So today we are talking about dupuytren's contracture, a common element that you see often around Coffee County. Can you elaborate on what this condition is?
Laura Tharp, M.D.: So dupuytren's disease is a genetic disease where the body makes scar tissue where you should not have any. It's found in the hand, on the Palm or surface of the hand and can occur in either one or both hands. And any of the digits in the hand. As it continues to grow, it will contract the fingers towards the Palm and leave the patient unable to straighten or fully extend the fingers.
Caitlin Whyte: Now, why is something like this so common in a rural region like yours?
Laura Tharp, M.D.: It's not particularly more common per se in a rural region.
It has a genetic predisposition. You can see it in any region. It's more commonly seen in people of Scandinavian disease.
Caitlin Whyte: Oh, that's so interesting. So how does something like this progressed? Does it typically start at one finger and work their way through? Or what do we see?
Laura Tharp, M.D.: Usually the patient will first notice a hard nodule or lump in the Palm of the hand. They can be quite painful when they first start progressing and then there'll be another knot and then another knot and they kind of start connecting the dots and where you get a long hard cord. The cord actually follows the path of the flexor tendon, the tenders that allow you to bend your fingers and they can anchor to the first joint or knuckle or to the second joint or knuckle in the finger.
Caitlin Whyte: Okay. So if this kind of condition is left untreated, what are some of the side effects? I mean, can this limit use of the hand completely?
Laura Tharp, M.D.: It Can. And unfortunately we do not know how to slow the progression or to prevent it in its entirety. Once you notice the noddles, unfortunately there's not a lot of treatment options until you actually start to have dupuytren's contractor, but the contractors can be severely functioned, limiting imagine not being able to get your hand in your pocket or to make a tight fist due to this.
Caitlin Whyte: So can patients who are experiencing this make a full recovery afterwards, is there a way to reverse it?
Laura Tharp, M.D.: There is a way to treat it, but unfortunately there are no ways to fully cure the problem, even with surgery or some of the newer treatments, which include an injectable. There will be a recurrence. Now, unfortunately we can't predict how long it will take for a recurrence to happen, or even identify any risk factors such as activity levels, medications, other co-morbidities that would make it worse or better, but there are things that you can do to improve quality of life.
Caitlin Whyte: And what are some of those things that we can do?
Laura Tharp, M.D.: One of the newer techniques is a medication called Xiaflex and that's an injectable that can be done in the office. It's a two day procedure where the first day the medication is injected after numbing the finger. And the second day, the patient returns for a manipulation in the office. Again, after numbing the finger, the goal of that shot is to rupture the cord to allow for extension of the digit. Other alternatives are a surgical excision of the cord. That done in an operating room, obviously.
And then it's an outpatient procedure where you go home the same day. Sometimes after both the Xiaflex injection or the surgical procedure, patients may need the help of an occupational therapist or a certified hand therapist to work on regaining grip strength, but reasonable recovery can be achieved.
Caitlin Whyte: Well Doctor wrapping up here. Is there anything else you'd like listeners to know about this?
Laura Tharp, M.D.: This is a very treatable condition. And one of the biggest things that we see in a rural area that someone's been afflicted with this for several years, making it much more challenging to get a good result. So I encourage anyone who believes they have a contracture or a nodule that they're unfamiliar with in their hand to come and have it checked out so we can help keep them as functional as long as.
Caitlin Whyte: Well, Dr. Tharp, I appreciate you taking the time to explain this to us. If this is a condition that has touched yourself or a loved one, and you have yet to seek help contact Dr. Laura Tharp with Orthopedic Surgeons of Georgia at 912-383-6575. That's 912-383-6575. Or visit them online at orthopedicsurgeonsofga.com
Vicki Lewis: We've decided to create this podcast, to educate our community and enlighten those throughout our great nation about rural health care. We hope you subscribe and enjoy Discussions with the Doc. Thank you for listening to this podcast, sponsored by Coffee Regional Medical Center, where our purpose is to serve, to heal, to save.
Caitlin Whyte: This concludes today's episode of Discussions with the Doc. We invite you to download subscribe, rate, and review our podcast on apple podcasts, Google podcasts, and Spotify. For more episodes and information on our providers and services. Visit us online at coffeeregional.org. This program aims to enhance your health and wellness knowledge by fulfilling the vision of Coffee Regional Medical Center. Healthy lifestyles, better lives. None of the information provided in this episode should serve as a diagnosis or approval of the treatment for any ailment.
The information and opinions provided in the podcast do not create any type of doctor, patient relationship by listening to this podcast. You agree not to use this podcast as medical advice to treat any medical condition and either yourself or others, including, but not limited to patients that you are. Consult your own physician for any medical issues that you may be having the opinions of the guests do not necessarily represent the opinion of Coffee Regional Medical Center.
Dupuytren's Contracture
Vicki Lewis: Welcome to Discussions with the Doc. This is a healthcare podcast brought to you by Coffee Regional Medical Center in Douglas, Georgia, where our mission is to provide exceptional care and wellness close to home. Join us as we learn more about rural healthcare in south.
Caitlin Whyte: Welcome back to another episode of Discussions with the Doc. Today, we are discussing a common hand condition found around Coffee County, dupuytren's contracture, and we are joined today by Dr. Laura Tharp, an orthopedic surgeon fellowship trained in hands, wrists and elbows. Thanks Doctor for joining the podcast.
Laura Tharp, M.D.: I thank you for having me. I'm glad to be here.
Caitlin Whyte: So today we are talking about dupuytren's contracture, a common element that you see often around Coffee County. Can you elaborate on what this condition is?
Laura Tharp, M.D.: So dupuytren's disease is a genetic disease where the body makes scar tissue where you should not have any. It's found in the hand, on the Palm or surface of the hand and can occur in either one or both hands. And any of the digits in the hand. As it continues to grow, it will contract the fingers towards the Palm and leave the patient unable to straighten or fully extend the fingers.
Caitlin Whyte: Now, why is something like this so common in a rural region like yours?
Laura Tharp, M.D.: It's not particularly more common per se in a rural region.
It has a genetic predisposition. You can see it in any region. It's more commonly seen in people of Scandinavian disease.
Caitlin Whyte: Oh, that's so interesting. So how does something like this progressed? Does it typically start at one finger and work their way through? Or what do we see?
Laura Tharp, M.D.: Usually the patient will first notice a hard nodule or lump in the Palm of the hand. They can be quite painful when they first start progressing and then there'll be another knot and then another knot and they kind of start connecting the dots and where you get a long hard cord. The cord actually follows the path of the flexor tendon, the tenders that allow you to bend your fingers and they can anchor to the first joint or knuckle or to the second joint or knuckle in the finger.
Caitlin Whyte: Okay. So if this kind of condition is left untreated, what are some of the side effects? I mean, can this limit use of the hand completely?
Laura Tharp, M.D.: It Can. And unfortunately we do not know how to slow the progression or to prevent it in its entirety. Once you notice the noddles, unfortunately there's not a lot of treatment options until you actually start to have dupuytren's contractor, but the contractors can be severely functioned, limiting imagine not being able to get your hand in your pocket or to make a tight fist due to this.
Caitlin Whyte: So can patients who are experiencing this make a full recovery afterwards, is there a way to reverse it?
Laura Tharp, M.D.: There is a way to treat it, but unfortunately there are no ways to fully cure the problem, even with surgery or some of the newer treatments, which include an injectable. There will be a recurrence. Now, unfortunately we can't predict how long it will take for a recurrence to happen, or even identify any risk factors such as activity levels, medications, other co-morbidities that would make it worse or better, but there are things that you can do to improve quality of life.
Caitlin Whyte: And what are some of those things that we can do?
Laura Tharp, M.D.: One of the newer techniques is a medication called Xiaflex and that's an injectable that can be done in the office. It's a two day procedure where the first day the medication is injected after numbing the finger. And the second day, the patient returns for a manipulation in the office. Again, after numbing the finger, the goal of that shot is to rupture the cord to allow for extension of the digit. Other alternatives are a surgical excision of the cord. That done in an operating room, obviously.
And then it's an outpatient procedure where you go home the same day. Sometimes after both the Xiaflex injection or the surgical procedure, patients may need the help of an occupational therapist or a certified hand therapist to work on regaining grip strength, but reasonable recovery can be achieved.
Caitlin Whyte: Well Doctor wrapping up here. Is there anything else you'd like listeners to know about this?
Laura Tharp, M.D.: This is a very treatable condition. And one of the biggest things that we see in a rural area that someone's been afflicted with this for several years, making it much more challenging to get a good result. So I encourage anyone who believes they have a contracture or a nodule that they're unfamiliar with in their hand to come and have it checked out so we can help keep them as functional as long as.
Caitlin Whyte: Well, Dr. Tharp, I appreciate you taking the time to explain this to us. If this is a condition that has touched yourself or a loved one, and you have yet to seek help contact Dr. Laura Tharp with Orthopedic Surgeons of Georgia at 912-383-6575. That's 912-383-6575. Or visit them online at orthopedicsurgeonsofga.com
Vicki Lewis: We've decided to create this podcast, to educate our community and enlighten those throughout our great nation about rural health care. We hope you subscribe and enjoy Discussions with the Doc. Thank you for listening to this podcast, sponsored by Coffee Regional Medical Center, where our purpose is to serve, to heal, to save.
Caitlin Whyte: This concludes today's episode of Discussions with the Doc. We invite you to download subscribe, rate, and review our podcast on apple podcasts, Google podcasts, and Spotify. For more episodes and information on our providers and services. Visit us online at coffeeregional.org. This program aims to enhance your health and wellness knowledge by fulfilling the vision of Coffee Regional Medical Center. Healthy lifestyles, better lives. None of the information provided in this episode should serve as a diagnosis or approval of the treatment for any ailment.
The information and opinions provided in the podcast do not create any type of doctor, patient relationship by listening to this podcast. You agree not to use this podcast as medical advice to treat any medical condition and either yourself or others, including, but not limited to patients that you are. Consult your own physician for any medical issues that you may be having the opinions of the guests do not necessarily represent the opinion of Coffee Regional Medical Center.