Dupuytren’s Contracture Causes, Symptoms & Treatment

Overview

Dupuytren’s contracture, also known as Dupuytren’s disease, is a hand condition that affects the fascia, a layer of fibrous tissue beneath the skin. Dupuytren’s disease causes this fascia to thicken and shorten over time, forming dense cords of tissue or small, firm nodules beneath the skin of the palm. Eventually, this may cause one or more fingers to bend toward the palm, known as Dupuytren’s contracture.

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

What causes Dupuytren’s Contracture?

While the exact cause of Dupuytren’s contracture is unknown, it is widely believed to have a hereditary component. If a close family member has been diagnosed with Dupuytren’s contracture, your risk of developing the condition is higher.

• How the Injury Occurs: Dupuytren’s contracture develops gradually as the fascia thickens and tightens, forming cords that slowly pull the fingers toward the palm over time.
• Common Everyday Causes: Although not caused by injury, everyday hand use may make the tightening more noticeable during tasks like gripping objects, shaking hands, or placing the hand flat on a surface.

Certain factors are known to increase the likelihood of Dupuytren’s contracture, including:

• Advanced age: The condition most commonly develops after age 50, as connective tissues naturally lose flexibility over time.
• Being male: Men are more likely to develop Dupuytren’s contracture and often experience more severe progression.
• Alcohol and tobacco use: Long-term alcohol consumption and smoking may contribute to tissue changes that trigger disease progression.
• Northern European or Scandinavian descent: The condition is more prevalent among individuals with ancestry from these regions.
• Certain medical conditions: Disorders such as diabetes or seizure conditions are associated with a higher incidence of Dupuytren’s contracture.

Symptoms

Dupuytren’s contracture is a progressive condition that develops slowly over several years. Common Dupuytren’s contracture symptoms include:

• One or more nodules in the palm: Small, firm lumps may appear under the skin and may or may not be tender to the touch.
• Thick cords under the skin: Bands of tightened tissue can form in the palm, gradually limiting finger movement.
• Finger contracture: One or more fingers may begin to bend toward the palm as the tissue bands tighten and shorten.

Non-operative treatment

Because Dupuytren’s disease progresses slowly, many people do not require treatment for years. In some cases, the condition never advances beyond small lumps in the palm.

When treatment becomes necessary, non-operative options are usually tried first, including:

• Splinting: Helps maintain finger extension and may slow worsening stiffness.
• Steroid injections: Reduce pain and inflammation and may help slow disease progression in some cases.
• Xiaflex® enzyme injections: Work by weakening and dissolving the contracted cords of 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 Dupuytren’s contracture 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.