What is Dupuytren's contracture?
Dupuytren’s contracture is a condition in the hand where the tissue under the skin in the palm and fingers starts thickening. As the tissue tightens or contracts from the thickening, the fingers curl forward.
Dupuytren’s contracture typically impacts the pinkie finger and ring finger of both hands. Dupuytren’s contracture can eventually lead to crippling hand deformities.
Causes of Dupuytren's contracture
Although the cause of Dupuytren's disease is not known, scientists have linked the disease to genetics.
Risk factors for Dupuytren's contracture
Risk factors of Dupuytren's contracture include:
- Gender — men are at higher risk for Dupuytren’s contracture.
- Age — older people are at higher risk for Dupuytren’s contracture.
- Heritage — Northern Europeans (English, Irish, Dutch, French) and Scandinavians (Finnish, Norwegian and Swedish) are at higher risk for Dupuytren’s contracture.
- Alcohol use — people who drink alcohol have a higher risk of developing Dupuytren’s contracture.
- Diabetes — people with diabetes are at higher risk for Dupuytren’s contracture.
- Seizure disorders — people who suffer from seizure disorders are at higher risk for Dupuytren’s contracture.
Symptoms of Dupuytren's contracture
The first sign or symptom of Dupuytren's disease is thickening of the skin on the palm of the hand.
Dupuytren’s contracture typically progresses slowly, and as it worsens, other symptoms of Dupuytren's disease appear, including:
- Skin on the palm of the hand may appear puckered or dimpled.
- A lump of tissue forms on the palm of the hand that is typically sensitive to touch.
- Cords of tissue form in the fingers under the skin that tighten in the late stages of the disease.
- The pinkie or ring finger may appear clenched.
- Inability to pick up large objects, place hands in pockets or perform everyday activities such as shaking hands.
- Inability to place hand flat on the table.
Diagnosis of Dupuytren’s contracture
Dupuytren's contracture is diagnosed in a physical exam by an orthopedic specialist or primary care physician.
Your physician will take a complete medical history and exam the fingers and the hands. In the exam, the physician will note where the nodules and cords are on the palm, examine the range of motion in the fingers and determine the amount of feeling in the fingers.
Treatments for Dupuytren's contracture
As of 2017, there is not a cure for Dupuytren’s contracture. Many people never progress past the early stages of the disease.
If the Dupuytren’s does progress, your orthopedic physician may offer one of the following surgical and non-surgical treatment options:
- Steroid injection
- Brace/splint
- Surgical treatment
Recovery from Dupuytren’s contracture
Recovery from Dupuytren’s contracture surgery is a long process. The more severe the condition, the longer it takes to recover.
Most patients will require hand therapy to restore full hand function. In some cases, Dupuytren’s contracture can reoccur because the surgery does not correct the cause of the issue.