Dupuytren's Contracture

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What is Dupuytren's contracture?

Dupuytren's contracture is a condition which involves the tightening and thickening of tissue under the skin of the fingers and palm. This tissue is known as the fascia, and is usually stretchy. The fibres which comprise the fascia run from the fingers to the palm. When you have Dupuytren's contracture, the fibres contract or tighten and the fingers curl into the palm. Sometimes Dupuytren's contracture can be so severe that it can lead to serious hand deformities and loss of function.

What causes Dupuytren's contracture?

The root cause of Dupuytren's contracture is not currently known. Injuries to the hand, or overuse, have been ruled out as a cause. However, there are certain factors which are understood to affect the fascia that could be influential.  It is understood that you are more likely to get Dupuytren's contracture if you drink a lot of alcohol, take certain types of epilepsy medication, have diabetes, or smoke.

Dupuytren's contracture also has a strong genetic link and can be passed down through family members. It is also found in people of Northern European descent. Research has also shown that men, especially those over 40, are more likely to get Dupuytren's contractures than women.

Symptoms of Dupuytren's contracture

The first Dupuytren's signs are the appearance of one or several nodules (lumps) under the skin of the palm. The lump(s) can feel sore initially, but this tenderness usually subsides. These lumps can lead to bands of abnormal tissue forming under the skin of the palm, eventually causing the fingers to bend into the palm and fingers. As the condition develops, it  becomes difficult to straighten the fingers.

The ring finger and little finger are most commonly affected by Dupuytren's contractures. It is normal for people with Dupuytren's contracture to experience the condition in both hands. In some cases, symptoms might be worse in one hand. The condition can lead to problems with everyday practical tasks.


Treatment options for Dupuytren's contracture

Methods of diagnosis for Dupuytren's contracture usually involve a physical examination of the hands and wrists, checking for nodules in the palm areas and an assessment of hand function.

While there is no known cure for Dupuytren's contractures, in some cases the condition is harmless and so slow to progress that no treatment is required. Treatment options for those who experience pain or restricted movement include a corticosteroid injection, which helps to reduce inflammation and ease pain, collagenase injection, which is an enzyme mixture that helps to dissolve thick tissue; and as a last resort, surgery to divide or remove the tissue bands in the palm, in order to help restore range of motion in the fingers.

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