Dupuytren’s contracture

Overview

This is a condition that gradually attacks the connective tissue under the skin of the palm. Hard nodules and cords of tissue form in the palm of the hand and below the fingers. These cords tighten and cause the fingers to pull toward the palm. The ring and little fingers are most commonly affected. Men suffer from this disease 5 times more often than women.

Symptoms

• Beginning
  • Between the ages of 40 and 60
  • Painless for many months and years
  • Skin on the palm appears puckered or dimpled
• Mainly affects the ring and little fingers
• Progressive formation of hard lumps and thickened cords
• Tissue continues to shrink, together with the joint capsules
  • Fingers can't be bent or straightened
  • Abnormal position of fingers
  • Fingers fixed in a bent position
  • Pain in the palm

Causes and treatment

Causes

• Largely unknown
• Family history
• Risk factors under discussion
  • Alcohol consumption, liver cirrhosis
  • Nicotine consumption
  • Diabetes
  • Epilepsy
  • Repeated hand injuries

Further treatment by your doctor / in hospital

Possible tests

• Examination of the hand

Possible therapies

• Will not heal spontaneously
• Initially, wait-and-see approach
• Non-surgical treatment
  • Localised radiation
  • Enzyme injection (collagenase)
  • Needle fasciotomy (rupturing of thickened cord)
• Surgical options
  • Puncturing and breaking the cord of tissue
  • Removing the cord of tissue
  • Removing the central tendon (fully or partially)

What can I do myself?

• No prevention is possible

When to see a doctor?

• Pain in the hand palm, fingers
• Thickening of tissue in the palm
• Impaired finger and hand function
  • Impossible to stretch a finger
  • Hand can't be put down flat any more
• Unaesthetic appearance

Synonyms

Dupuytren’s contracture, Dupuytren's disease