Dupuytren’s Disease/Contracture

Dupu

ytren’s disease or contracture is an abnormal thickening of the fascia, or soft tissue under the skin.  It often begins with firm “lumps” in the palm.  “Cords” can develop, extending from the palm towards the fingers, often the ring and small fingers.  Ultimately, these might cause the fingers to contract or bend into the palm.  Sometimes, nodules can be seen on the knuckles of the fingers or in the soles of the feet.

The cause of Dupuytren’s is unknown, but it is more frequently found in men over age 40 and those of northern European ancestry.

The initial nodules can be uncomfortable but not usually painful.  Contracture of the fingers can cause problems with your daily activities.  Unfortunately, there is no way to predict whether and to what extent your disease will progress, although earlier age of onset usually leads to more se

vere disease.

Patients without or with minimal contractures can be observed.  As contractures occur and progress, however, surgery to improve finger position and function can be helpful.  The major risks of surgery are recurrence of the contracture, nerve injury leading to loss of sensation, and wound problems.  Extensive hand therapy including splinting usually is included in the postoperative course.

An injectable substance that might help treat Dupuytren’s contractures currently is being investigated in clinical trials.