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Dupuytren’s contracture

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Definition   

Dupuytren's contracture is a painless thickening and contracture of tissue beneath the skin on the palm of the hand and fingers. Progressive contracture may result in deformity and loss of function of the hand.

Causes, incidence, and risk factors   

The cause of this contracture is unknown, but minor trauma and genetic predisposition may play a role. One or both hands may be affected. The ring finger is affected most often, followed by the little, middle, and index fingers.

A small, painless nodule develops in the connective tissue and eventually develops into a cord-like band. Extension of the fingers becomes difficult to impossible with advanced cases.

The condition becomes more common after the age of 40, and men are affected more often than women. Risk factors are alcoholism, epilepsy, pulmonary tuberculosis, diabetes, and liver disease.

Symptoms   

Signs and tests   

A physical examination of the palm by touch (palpation) confirms the presence of thickened scar tissue (fibrosis) and contracture. Restriction of motion is common.

Treatment   

Exercises, warm water baths, or splints may be helpful. The progression of the contracture is monitored.

Surgery may be performed to release the contracture, depending on the severity of the condition. Normal movement of the fingers is usually restored by surgery followed by physical therapy exercises for the hand.

Expectations (prognosis)   

The disorder progresses at an unpredictable rate. Surgical treatment can usually restore normal movement to the fingers. The disease can recur following surgery in some cases.

Complications   

Calling your health care provider   

Call your health care provider if symptoms indicate you may have this disorder.

Prevention   

Awareness of risk factors may allow early detection and treatment.

Update Date: 8/3/2004

Updated by: Kevin B. Freedman, M.D., Section of Sports Medicine, Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.

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