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Hand and Wrist · Hand and Upper Extremity

De Quervain Tenosynovitis

Inflammation of the two tendons that run along the thumb side of the wrist, causing sharp pain with lifting, gripping and turning the wrist.

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Hand and Wrist · Hand and Upper Extremity

Dupuytren Contracture

A thickening of the tissue under the skin of the palm into nodules and cords that slowly pull the fingers toward the palm until the hand will not lie flat.

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Hand and Wrist · Hand and Upper Extremity

Ganglion Cysts

A benign fluid-filled lump that balloons from a joint or tendon sheath, most often on the back of the wrist, that can ache, change size or press on a nerve.

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Hand and Wrist · Hand and Upper Extremity

Hand and Wrist Osteoarthritis

Wear of the cartilage in the small joints of the fingers and wrist, causing stiffness, swelling, bony knuckle enlargement and pain with gripping.

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Elbow · Hand and Upper Extremity

Distal Biceps Rupture

A tear of the biceps tendon from the bone at the elbow, with a pop, bruising, a bunched-up muscle and lost strength turning the palm up. Time-sensitive.

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Hand and Wrist · Hand and Upper Extremity

Scaphoid Fracture

A break in the small wrist bone below the thumb, often mistaken for a sprain, that heals poorly because of its blood supply and leads to arthritis if missed.

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Hand and Wrist · Hand and Upper Extremity

Wrist Instability

A torn ligament between the small bones of the wrist, most often the scapholunate ligament, that lets the bones shift out of alignment and wear the joint.

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Hand and Wrist · Hand and Upper Extremity

Hand and Wrist Tendon Injuries

Cuts, ruptures and overuse injuries of the tendons that bend and straighten the fingers and wrist, including mallet finger, jersey finger and tendinitis.

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Hand and Wrist · Hand and Upper Extremity

Hand and Wrist Ligament Sprains

Stretched or torn ligaments in the wrist, thumb and fingers, including skier thumb and jammed fingers. Most heal with splinting; complete tears may need repair.

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Hand and Wrist · Hand and Upper Extremity

Nerve Injuries of the Hand and Arm

Cuts, crush injuries and stretch injuries to the nerves of the hand and arm, causing numbness and weakness. Timing matters because nerves recover slowly and only when repaired early.

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Hand and Wrist · Hand and Upper Extremity

Finger and Thumb Dislocations

A finger or thumb joint knocked out of place, usually by a ball or a fall. Reduced promptly, then protected so the ligaments heal and the joint stays stable.

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Hand and Wrist · Hand and Upper Extremity

TFCC Tear

A tear of the cartilage and ligament complex on the small-finger side of the wrist, causing pain with twisting and weight bearing. From a fall or from years of load.

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What it is

Dupuytren Contracture

Dupuytren disease is an abnormal thickening of the fascia, the layer between the skin and the tendons of the palm.

It forms nodules, then cords, and the cords contract over years, bending the fingers.It is not a tendon problem and it is not cancer, though it is progressive.

Treated by

Toby Johnson, MD, Hand and Upper Extremity surgeon at Ridgeline Orthopedic Specialists

Dr. JohnsonHand and Upper Extremity

M. Shane Frazier, DO, Hand and Upper Extremity surgeon at Ridgeline Orthopedic Specialists

Dr. FrazierHand and Upper Extremity

Travis Peterson, DO, Hand and Upper Extremity surgeon at Ridgeline Orthopedic Specialists

Dr. PetersonHand and Upper Extremity

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or call801-640-0000

Dupuytren Contracture

Symptoms

A firm lump or pit in the palm near the base of the ring or small finger.Later, a visible cord running from palm to finger and a finger that will not fully straighten. Difficulty laying the hand flat, wearing gloves, or shaking hands.

It is usually painless.

Common signs

Firm lump or pit in the palm

Cord running to the finger

Finger will not fully straighten

Hand will not lie flat

See us sooner if

Rapid change over weeks

Painful nodule

Dupuytren Contracture

Causes

Strongly inherited and most common in people of northern European descent, men, and those over fifty.Diabetes, smoking, heavy alcohol use and seizure medications increase the risk.Despite the folklore, manual labor is not a clear cause.

Dupuytren Contracture

How We Diagnose It

The diagnosis is by exam.The tabletop test, whether the hand can lie flat, tracks progression. No imaging is needed.We measure each joint angle so change over time is documented.Needle and enzyme releases happen in the office; open surgery is scheduled at a Provo or Orem surgery center. Dr. Johnson, Dr. Frazier and Dr. Peterson operate at Utah Valley Hospital and Orem Community Hospital.

Dupuytren Contracture

Treatment Options

Nodules without contracture are observed; nothing is proven to stop progression.

When a finger cannot straighten enough to lay the hand flat, options are needle aponeurotomy, collagenase enzyme injection, or open fasciectomy.Each trades recovery time against durability, and your surgeon will explain which fits your hand.

Your options

Non-surgical

Observation

Needle release

Enzyme injection

Surgical

Fasciectomy

Dupuytren Contracture Release

Trigger Finger Release

Dupuytren Contracture

Procedures That Address It

Dupuytren Contracture Release

Trigger Finger Release

Dupuytren Contracture

Surgeons Who Treat It

Dr. Johnson, MD

Weill Cornell graduate, hand fellowship at Allegheny General. Twenty-one years in practice and seventeen as a collegiate team physician.

Dr. Frazier, DO

Fellowship trained in hand and upper extremity surgery at the University of Pittsburgh. Seventeen years in practice. Fluent in Spanish.

Dr. Peterson, DO

Hand surgery fellowship at UMass Chan. Office-based, wide-awake carpal tunnel release. Fifteen years in practice. Speaks German.

Request an appointment

or call801-640-0000

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Two clinics, one number to call or text. Same-day appointments for acute injuries whenever we can. The front desk will match you with the right surgeon.

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Provo1055 N 300 W, Ste 104

Orem700 W 800 N, Ste 330

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