Peter G. Fitzgibbons, MD
Hand & Upper Extremity Surgeon
Dupuytren’s Contracture is a hand condition where thickening of the underlying fibrous tissues of the palm cause the fingers to bend inward. Patients with this condition are unable to fully straighten the affected fingers.
It is caused from excessive production of collagen which is deposited under the skin. It commonly occurs in the ring finger and little finger. Occasionally the middle finger is affected but the thumb and index finger are rarely affected. Dupuytren’s contracture is a condition that usually progresses slowly over many years and is not usually painful. However, some cases may progress rapidly and be painful to the patient.
The most commonly observed symptoms of Dupuytren's contracture are lumps or nodules in the palm of the hand, difficulty in straightening the fingers, and contracture of the nodules which form tough bands under the skin.
Causes and risk factors
The cause of Dupuytren’s contracture is unknown. However, there are certain risk factors that may increase your chance of developing the condition. These can include the following:
Dupuytren's contracture is diagnosed based on the patient's history and physical examination without any special tests required. The physical examination may involve pressing on different parts of your hands and fingers to assess for hardened knots or tough bands of tissue.
You may not need treatment for Dupuytren’s contracture if the condition is not affecting your ability to perform daily activities. However, if you are experiencing pain or are having difficulty using your hands for everyday activities, your surgeon will recommend conservative treatment options to treat your condition. Treatment options will vary depending on the severity of the condition. The conservative approaches include:
If conservative treatment options fail to resolve the condition and symptoms persist for 6 months or more and your quality of life is adversely affected, your surgeon may recommend a surgical procedure to open the tendon sheath and allow more room for tendon movement.
This surgery is usually performed in an operating room under local or regional anesthesia on an outpatient basis as day surgery. Your surgeon makes a small incision to the affected palm area.
The surgeon then removes the thickened fibrous tissue causing the contracture.
The incision is then closed with sutures and covered with a sterile dressing.
Complications can be medical (general) or specific to hand surgery. Medical complications include those of the anesthetic and your general well-being. Some of the complications associated with hand surgery include: