Dupuytren’s Contracture
What is Dupuytren’s contracture?
Dupuytren’s contracture is a deformity affecting the hand. In cases of Dupuytren’s contracture, the joints of the fingers may become permanently locked in a flexed position.
Dupuytren’s contracture most commonly affects men over 50 years of age. It is four times less likely to affect women and usually occurs later in life with less severity. On average, Dupuytren’s contracture affects one hand, often the right, regardless of dexterity.
Dupuytren’s contracture may also be known as contraction of palmar fascia, Dupuytren contracture/disease, familial palmar fibromatosis, palmar fascial fibromatosis, and palmar fibromas.
What are the symptoms of primary Dupuytren’s contracture?
The progression of Dupuytren’s contraction is often slow. Sometimes it takes years to develop. Dupuytren’s contracture begins as a thickening of the skin. Thickening may occur on the palm and/or hand. The skin of the hand/palm may become puckered or dimpled as Dupuytren’s contraction progresses. In some cases a firm lump may develop on the palm and become sensitive to touch.
In the later stages, cords form under the skin which may extend from the palm to the fingers. Over time these cords of tissue tighten and pull the fingers towards the palm.
What causes Dupuytren’s contracture?
The exact causes of Dupuytren’s contracture remain unknown. There is no evidence suggesting that injury or repeated use of the hands leads to Dupuytren’s contracture.
The most common cause appears to be familial genetics. Dupuytren’s contracture has been observed to pass in both autosomal dominant patterns, and mitochondrial patterns.
How is Dupuytren’s contracture diagnosed?
Dupuytren’s contracture can be diagnosed through a physical exam by a doctor or through genetic testing.
What are the treatments for Dupuytren’s contracture?
If progression is slow and does not disrupt daily function or cause pain, treatment may not be necessary.
In cases where treatment is necessary, the only method of treatment is to remove or break the cords of tissue contracting the fingers. The most common techniques involve puncturing the cords with needles inserted through the skin, softening them with an enzyme injection, and surgical removal of tissue cords in advanced cases.