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Dupuytren’s Contracture Causes, Symptoms & Treatment

Dupuytren’s contracture, also called Dupuytren’s disease, is a hand deformity that affects the fascia — a layer of fibrous tissue beneath your skin. Dupuytren’s disease causes the fascia to thicken and tighten over time, resulting in dense bands of tissue or small, hard lumps under the skin of your palm. Eventually, this can cause one or more fingers to bend toward the palm, known as Dupuytren’s contracture.

Dupuytren’s Contracture Hero Image 2

Dupuytren’s contracture, also called Dupuytren’s disease, is a hand deformity that affects the fascia — a layer of fibrous tissue beneath your skin. Dupuytren’s disease causes the fascia to thicken and tighten over time, resulting in dense bands of tissue or small, hard lumps under the skin of your palm. Eventually, this can cause one or more fingers to bend toward the palm, known as Dupuytren’s contracture.

Worsening Dupuytren’s contracture can interfere with your ability to use your hand for everyday activities, like getting dressed and preparing food.

What causes Dupuytren’s Contracture?

While the exact cause of Dupuytren’s contracture is unknown, it’s believed that the condition is hereditary. This means that if you have a family member who has been diagnosed with Dupuytren’s contracture, you’re at an increased risk of developing the condition.

We also know that certain factors can increase the risk of Dupuytren’s contracture, including:

Advanced age — Dupuytren’s contracture typically occurs after age 50

  • Being male
  • Alcohol and tobacco use
  • Being of northern European or Scandinavian descent
  • Having certain medical conditions, such as diabetes or a seizure disorder

Symptoms

Dupuytren’s contracture is a progressive disease that develops slowly over the years. Signs and symptoms of Dupuytren’s contracture include:

  • One or more nodules or lumps in the palm that may or may not be tender
  • Cords or thick bands of tissue under the skin that may restrict finger movement
  • Contracture or bending of one or more fingers as the bands of tissue tighten

When to see a doctor

See your doctor if you notice small lumps or cords of tissue beneath the skin in the palms of your hands.

During your appointment, your doctor will ask you about your symptoms and will examine your hand. Because Dupuytren’s contracture can run in families, they may ask if you know of any relatives with the disease.

Your doctor will carefully examine your hand and fingers, noting the number and location of nodules and cords, and will assess the range of motion of your thumb and fingers. In some cases, your doctor may take clinical photographs of your hand to evaluate disease progression over time.

Your doctor may order X-rays to rule out other potential causes of your symptoms, but usually, X-rays are not necessary.

Non-operative treatment

 

Because Dupuytren’s disease progresses slowly, you may not need treatment for many years. For some, the condition never worsens beyond developing small lumps in the palm.

When treatment is necessary, non-operative methods are generally used first, including:

  • Splinting the affected finger
  • Steroid injections to relieve pain and, in some cases, slow the progression of the contracture
  • Xiaflex® enzyme injections to weaken and dissolve contracted tissue
  • Needle aponeurotomy (a minimally invasive procedure that breaks apart the diseased tissue

Try these exercises to help address your condition:

Below is a PDF of the exercise program.

Dupuytren’s Contracture 

Surgical Treatment

 

If Dupuytren’s contracture interferes with your ability to use your hand, and non-operative treatments fail to relieve your symptoms, your doctor may recommend surgery.

The most common surgical treatments for Dupuytren’s contracture are:

  • Fasciotomy: A procedure that removes thickened fascia in the hand to relieve swelling and pressure.
  • Subtotal palmar fasciectomy: A procedure that involves removing as much abnormal tissue as possible through an incision in the shape of a zig-zag.

The goal of surgery is to improve the functioning of your hand. However, there is a risk that the fascia and cords can thicken again in the future.

Recovery

 

There’s no known cure for Dupuytren’s contracture, but treatment can buy you time by reducing the tightening effect of the cords. Most people experience symptom relief after surgery, but about 20% of patients experience a significant degree of disease recurrence.

People who receive non-operative treatment may notice an improvement in their symptoms after about 3 to 6 months. If you’ve undergone surgery, you’ll need to complete a physical therapy regimen afterward, and you can expect to make a complete recovery in about 1 year.

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