Dupuytren's contracture
About Dupuytren's contracture
Dupuytren's contracture is a soft tissue condition that causes a progressive deformity of the hand slowly over time. The cause is unknown, but is thought to be an inherited disorder and is seen more frequently with increasing age. The condition is more common in men than in women and in people of Northern European heritage. Thick tissue forms under the skin over time and impedes the movement of the tendons in the hand. This causes the hand to flex and contract causing decreased function of the affected hand. Over time, the fingers bend towards the palm and cannot be straightened. The ring and little finger are most commonly affected while the index finger and thumb are usually spared.Symptoms
Symptoms include bumps or nodules in the palm of the hand, decreased range of motion of the hand and a loss of dexterity. Dupuytren's contracture progresses slowly and is usually painless. The condition has not been associated with an injury or repetitive hand use.Tests & Diagnostics
A history and physical will be performed. A doctor can often make the diagnosis based on exam findings alone. Diabetes is associated with this disease, so a fasting blood glucose may be ordered if your history suggests the possibility of diabetes. An Xray of the affected hand may also be ordered if the diagnosis is in question.Common tests: X-ray, Fasting blood glucose .
Conventional treatment summary
Treatment depends on the stage of the disease. Initial therapy may be primarily performed by a physical therapist with a combination of stretching, splinting, massage and therapeutic modalities. Steroid injections may also be performed but are associated with skin discoloration and the atrophy of the fat in the hand. An injection of collagenase into the soft tissue of the affected fingers, followed by soft tissue manipulation has shown favorable results for early to mid progression of the contracture. Finally, surgical intervention is often performed in the later stages of disease to remove diseased fascia (connective tissue under the skin of the hand).Medical specialties
Internal Medicine · Hand Surgery · Plastic Surgery · Family Practice · Orthopedic Hand Surgery
This page is educational content, not medical advice. Always consult a qualified clinician for diagnosis and treatment of Dupuytren's contracture.