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Suggest treatment for vikings disease

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Posted on Tue, 17 May 2016
Question: I've been diagnosed with a hand neuropathy condition commonly known as "Vikings Disease". Can you provide me some details on surgical and/or non-surgical treatments ?


I had an EMG test yesterday and it confirmed the diagnosis.
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern.

Viking's disease or Dupuytren's contracture actually is not a neuropathy, it involves the connective tissue, leading to thickening and shortening of the connective tissue fascia in your palm. Perhaps the doctors by EMG have excluded other potential causes due to nerve damage, not evidenced Viking's disease as there is no test for that.

Now regarding management. In initial stages physical therapy is used with stretching exercises, use of heat and ultrasonographic shockwaves, use of splints etc.
Also in early stages radiotherapy may help, but is not effective in advanced ones.

The nonsurgical novelty of recent years has been the introduction of injections of collagenase, an enzyme which weakens and dissolves the thickened tissue. It is not a single but a cycle of injections for 30 days.

Other nonsurgical treatments may include 5-fluorouracil, Imiquimod, botulinum toxin injections, but all those need further studies, not approved as single therapy.

Surgery on the other hand remains the most effective approach and should be done if there is an over 30º contracture. It consists in cutting and removing the contracted tissue. In terms of comparing injections with surgery, more studies are needed, but from the available ones surgery remains superior for advanced cases.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3669 Questions

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Suggest treatment for vikings disease

Brief Answer: Read below. Detailed Answer: I read your question carefully and I understand your concern. Viking's disease or Dupuytren's contracture actually is not a neuropathy, it involves the connective tissue, leading to thickening and shortening of the connective tissue fascia in your palm. Perhaps the doctors by EMG have excluded other potential causes due to nerve damage, not evidenced Viking's disease as there is no test for that. Now regarding management. In initial stages physical therapy is used with stretching exercises, use of heat and ultrasonographic shockwaves, use of splints etc. Also in early stages radiotherapy may help, but is not effective in advanced ones. The nonsurgical novelty of recent years has been the introduction of injections of collagenase, an enzyme which weakens and dissolves the thickened tissue. It is not a single but a cycle of injections for 30 days. Other nonsurgical treatments may include 5-fluorouracil, Imiquimod, botulinum toxin injections, but all those need further studies, not approved as single therapy. Surgery on the other hand remains the most effective approach and should be done if there is an over 30º contracture. It consists in cutting and removing the contracted tissue. In terms of comparing injections with surgery, more studies are needed, but from the available ones surgery remains superior for advanced cases. I remain at your disposal for other questions.