Dupuytren’s Contracture

Dupuytren’s contracture is a hand deformity caused by a thickening of the fascia (a connective tissue beneath the skin) on the palm of the hand. Knots of tissue form producing lumps or a thick cord that pulls one or more fingers in a bent direction. Fingers affected by Dupuytren’s contracture cannot be straightened completely, leading to difficulty performing daily activities.

Causes

The exact cause of Dupuytren’s contracture is still unknown. It is not believed to be the result of a hand injury or repetitive use of the hand. White males of northern European and Scandinavian descent over age 60 are most commonly affected. It is also prevalent in patients with diabetes and a history of tobacco and alcohol use.

Symptoms

Symptoms of Dupuytren’s contracture include a hard lump under the skin of the palm in line with the ring or little fingers. As the condition progresses, the lump may be sensitive to touch but isn’t usually painful. When the cords of tissue begin to tighten, the affected fingers will begin to pull toward the palm and are unable to be straightened. Dupuytren’s contracture can occur in both hands, although one hand tends to be impacted more severely than the other.

Diagnosis

Physicians can generally diagnose Dupuytren’s contracture by examining the hands without further testing. Common signs of the condition include puckering of the palm’s skin, toughened knots or bands of tissue, and the inability to fully flatten the fingers.

Treatment

There is no treatment to cure or prevent Dupuytren’s contracture. The condition is usually painless and has minimal impact on the ability to use the hands. Treatment to relieve severe finger contracture can include surgical excision of the thickened fascial tissue or needle release of the contracture. Injecting an enzyme called collagenese can also be used to weaken the contracted cord so it can be pulled or broken.