Dupuytrens Contracture


Dupuytrens contracture is a condition in which the fingers of the hand bend in towards the palm. It is caused by a thickening of the tough connective tissues in the hand which can lead to the fingers being drawn into the palm.

Dupuytrens contracture is a condition of the hands and fingers. It is sometimes called Dupuytrens disease because not everyone with this condition develops contractures.

At first, there is a thickening of some tissues under the skin in the palm. If the disease progresses you may develop a contracture of one or more fingers. A contracture is when affected fingers bend (contract) towards the palm and cannot be fully straightened.

Dupuytrens contracture is not usually painful. The main problem is that if one or more contractures develop, you cannot use the affected fingers properly. The extent of a contracture varies greatly from mild to severe. Sometimes just one hand is affected. Commonly, it affects both hands.

The reason why this tissue becomes thickened is not known. There seems to be a genetic factor as it has a tendency to run in some families and it is more common in some countries – mainly northern European. It is more common in people with diabetes, epilepsy, and alcohol dependence – but most people with Dupuytrens contracture do not have any of these other conditions. In some cases it is thought that an injury to the hand may trigger the condition to start in someone who is genetically prone to develop the condition.

However, in most people with Dupuytrens contracture, there is no known cause or associated illness or injury. It is not due to your type of job, vibrating tools, manual work, or other working environments.

Dupuytrens contracture most often presents in its earliest stages as a simple thickening of the fascia of the palm, which causes the palm to feel tough and bumpy. At first, the bumps will be painful, but over time the pain will go away, although the condition will continue to progress.

Over time, it will slowly grow to the point that all of the fingers are curled into the palm, rendering the hand almost useless. The little and ring fingers are most commonly affected, and the middle finger can be included in some severe cases, but the index finger and thumb are seldom afflicted.

The operations for Dupuytrens Disease are usually day case procedures, which means you can arrive and leave on the same day. The operations vary depending on the extent of your disease:

  • “Percutaneous fascietomy”, where a little anaesthetic is given and a small needle is used to cut the cord.
  • “Palmar fasciectomy”, where there is a zigzag wound from your palm to the middle of your finger. This is usually done with a full anaesthetic.
  • “Dermofasciectomy and skin graft”, where the disease is extensive or recurrent and the skin is involved. Here there is a zigzag wound, but also a patch of skin is taken from your arm to fill a defect. This is usually done with a full anaesthetic.

To learn more about Dupuytrens Disease and the treatment options available, contact our helpful team today.

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