Dupuytren's Contracture

Overview

Dupuytren’s contracture, also known as Morbus Dupuytren, Dupuytren’s disease or palmar fibromatosis, develops when fibrous tissue grows in your palms and attaches to the tendons causing your fingers to pull toward the middle of the hand. The affected fingers cannot be straightened, which impacts your ability to perform everyday tasks such as shaking someone’s hand.

Typically, Dupuytren’s contracture affects the pinky and ring fingers and is common in elderly men of Northern European descent.

Your doctor will develop a treatment plan to slow the progression of the disease and relieve your symptoms.

Dupuytren’s contracture causes

The cause of Dupuytren’s Contracture is unknown.

Dupuytren’s contracture symptoms

The primary sign of Dupuytren's contracture is the thickening of the skin in the palm.

Other symptoms include:

• Puckered skin on the palm of your hands.
• A firm lump of tissue may grow on the palm of your hand.

As the condition progresses, cords of skin form under the skin in the palm of your hand. In some cases, these cords extend up to your fingers. Over time, the cords will tighten, and your fingers will be pulled up toward your palm.

Dupuytren’s contracture complications

If left untreated, Dupuytren's contracture can be debilitating. As the condition progresses, it can limit your ability to open your hand fully, grasp small objects, or insert your hands in narrow spaces.

Dupuytren’s contracture risk factors

Risk factors that may increase your likelihood of getting Dupuytren’s Contracture include:

• Gender — men are more likely to develop Dupuytren’s contracture.
• Age — the condition typically develops after the age of 40.
• Alcohol consumption.
• Genetics — it runs in families.
• Diabetes
• Being of Celtic or Scandinavian ancestry.

If a woman develops Dupuytren's contracture, it is generally later, and they will have less severe symptoms.

Dupuytren’s contracture prevention

There are no preventive methods to avoid developing Dupuytren’s contracture.

Dupuytren’s contracture diagnosis

Your doctor can diagnose Dupuytren's contracture. During a clinic visit, your doctor will examine your hands looking for skin puckering and tight bands of tissue under the skin in your palm. Your doctor may also instruct you to place your hand flat on a table to determine if you can fully flatten your fingers.

Imaging tests are rarely needed.

Dupuytren’s contracture treatment

There is not a cure for Dupuytren’s contracture. If your condition is not affecting your ability to do everyday tasks, you may not need treatment.

If you have severe symptoms associated with Dupuytren’s contracture, treatments include:

• Corticosteroid injection directly into the nodule. The injection may alleviate the pain and slow the progression of the condition.
• Collagenase injections. This new FDA approved treatment involves injecting the enzyme collagenase into the cords in an effort to weaken them. Your doctor will then break the cords, which will allow you to straighten your fingers.
• Surgery may be able to help you open your fingers again. You may need surgery if the condition is affecting your ability to use your hand or the tissue growing in the hands is wrapping around arteries or nerves, increasing the risk to them. Your doctor will outline the surgical options and recommend the option best for you. The most commonly performed surgical procedures to treat Dupuytren's contracture are fasciotomy or subtotal palmar fasciectomy.
  • Your doctor will make a cut in the connective tissue to help relieve any built-up tension. The tissue will be left in the hand, and the wound may be left open to heal. You will need to wear a splint while the wound heals.
  • Subtotal palmar fasciectomy. Your surgeon will remove all the connective tissue. You may need a skin graft to help the wound heal properly.
• Physical and occupational therapy. To regain the function of your hand, a combination of physical and occupational therapy may be necessary.

When to Seek Care

Contact your doctor if your symptoms are worsening or you are developing new symptoms.

Next Steps

Before your appointment, write down any questions you have for your doctor.

If you are diagnosed with Dupuytren’s contracture, follow your doctor’s treatment and recovery plan carefully. If your symptoms worsen or you experience severe pain associated with your condition, call your doctor right away for the next steps.

There is no cure for Dupuytren’s contracture, but your symptoms can improve.