Dupuytren’s Disease

Dupuytren’s contracture

Dupuytren’s contracture, is a condition in which one or more fingers become permanently bent in a flexed position. It usually begins as small hard nodules just under the skin of the palm. It then worsens over time until the fingers can no longer be straightened.

While typically not painful some aching or itching may be present. The ring finger followed by the little and middle fingers are most commonly affected. It can interfere with putting on gloves, washing face, preparing food, writing, and other activities.

Dupuytren’s most often occurs in males over the age of 50. It mostly affects white people and is rare among Asians and Africans. In the United States about 5% of people are affected at some point in time, while in Norway about 30% of men over 60 years old have the condition. In the United Kingdom, about 20% of people over 65 have some form of the disease. It is named after Guillaume Dupuytren, who first described the underlying mechanism in 1833. The cause is unknown.

Risk factors

include family history, alcoholism, smoking, thyroid problems, liver disease, diabetes, previous hand trauma, and epilepsy. The underlying mechanism involves the formation of abnormal connective tissue within the palmar fascia. Diagnosis is usually based on symptoms.

Treatment

Initial treatment is typically with steroid injections into the affected area and physical therapy.  Among those who worsen, clostridial collagenase injections or surgery may be tried. The condition may recur despite treatment.

Further Information