Scleroderma and other types of connective tissue disorders cause a limited range of motion, aesthetic issues and may even interfere with the function of internal organs. As a triple board-certified plastic and reconstructive surgeon and fellowship trained hand and peripheral nerve specialist, John R. Barbour, MD, FACS, offers scleroderma and connective tissue disorder treatment for children and adults in the Washington, DC area, including Fairfax, Arlington, Alexandria and surrounding communities in Virginia.
Scleroderma and the Hands
Tightening of areas of skin on the hands in combination with Raynaud’s disease often produces finger ulcers that can become painful and infected. Scleroderma also produces flexion contractures of the PIP and DIP joints of the hands that can cause reduced range of motion of the fingers and eventually limit the use of the hands.
Treatments for Scleroderma
Using over the counter anti-inflammatory medications as well as an antibiotic ointment on fingertip ulcers is often the first step of treatment for scleroderma that is affecting the hands. Immunosuppressive therapy is also frequently used to control the body’s inflammatory response and halt the progression of scleroderma. Dr. Barbour treats fingertip ulcerations with debridement and if necessary for chronic ulcers, surgical placement of dermal regeneration template (INTEGRA®) to facilitate healing. The goal of these treatments is to promote healing and prevent infection, with a focus on preserving finger length and preventing infection that could result in amputation. Treatment for Raynaud’s Disease can also help prevent fingertip ulcers including Lipogems fat grafting to the palm and fingers to increase local vascularization and Botox to increase blood flow to fingertips.
If the progression of scleroderma has limited hand function due to flexion contractures, arthrodesis (joint fusion) to correctly position fingers and increase function can be done. During this procedure Dr. Barbour surgically extends and re-positions the fingers to a more functional alignment, then surgically immobilizes the joints by fusion of adjacent bones.
Treatment and progression of scleroderma is very specific to each patient and they should consult with Dr. Barbour about a plan of care.
Scleroderma affects patients of all ages in the Washington, DC area, including Fairfax, Arlington, Alexandria and surrounding communities in Virginia. Contact Barbour Plastic Surgery to schedule a personal consultation and learn more about treatment options.
