Dupuytren's Contracture

Dupuytren’s contracture is characterized by the formation of nodules and thickened tissue in the palmar fascia, the connective tissue that extends from the palm to the fingers. Over time, this tissue contracts, pulling the fingers inward. The condition usually affects the ring and little fingers but can involve other fingers as well.

Causes and Risk Factors

The exact cause of Dupuytren’s contracture is not fully understood, but several factors may contribute to its development:

• Genetics: A family history of Dupuytren’s contracture increases the likelihood of developing the condition. It is more common in individuals with a genetic predisposition.
• Age: The condition typically develops in adults over the age of 50 and is more common in men than women.
• Ethnicity: It is more prevalent in people of Northern European descent.
• Lifestyle Factors: Chronic alcohol consumption and smoking may be associated with a higher risk of developing Dupuytren’s contracture.
• Medical Conditions: Certain health conditions, such as diabetes, can increase the risk of developing Dupuytren’s contracture.

Symptoms of Dupuytren’s Contracture

Symptoms of Dupuytren’s contracture can vary depending on the severity of the condition:

• Nodules: Small, firm lumps or nodules may develop in the palm of the hand, often at the base of the fingers. These nodules can be tender or painless.
• Thickened Tissue: The tissue under the skin becomes thickened and forms a cord-like structure that can be felt under the skin.
• Finger Contractures: As the condition progresses, one or more fingers begin to bend towards the palm, making it difficult to fully extend the fingers.
• Limited Hand Function: Reduced ability to perform tasks that require a flat hand, such as shaking hands, gripping objects, or putting hands in pockets.

Treatment Options for Dupuytren’s Contracture

Treatment for Dupuytren’s contracture depends on the severity of the condition and the impact on hand function. Common approaches include:

• Observation: In mild cases with minimal impact on hand function, regular monitoring and observation may be sufficient.
• Splinting: Custom splints may be used to stretch the affected fingers and slow the progression of contractures.
• Physical Therapy: Exercises and stretching techniques may help improve hand function and manage symptoms.
• Needle Aponeurotomy: A minimally invasive procedure where a needle is used to break up the thickened tissue in the palm, allowing the fingers to straighten.
• Collagenase Injection: An injection of collagenase enzyme is used to dissolve the thickened tissue, followed by manipulation of the fingers to straighten them.
• Surgery: For more severe cases, surgical intervention may be required to remove or release the thickened tissue. Surgery is usually considered when contractures are significant and affect hand function.