Dupuytren’s Contracture

What is a Dupuytren’s Contracture?

Dupuytren’s Contracture is a condition in the palm of the hand, that affects a layer of tissue (fascia) that lies under the skin. Thickening of this tissue potentially causes the fingers to bend or contract over time.

Presentation:

The thickened fascia may cause nodules or bumps in the palm of the hand or the fingers.  A cord like thickening may cause the fingers to bend.  Diagnosis can be difficult in the early stages. The presentation and rate of progression of this condition may vary. The cords may shorten overtime, causing joint and soft tissue contracture. Ultimately, these contractures may impact on day to day function including placing your hand in your pocket or washing your face.

The ring and little fingers are most commonly involved, but any part of the hand may be affected.

Treatment:

Early assessment to confirm the diagnosis and to determine the best course of management is recommended. In the early stages of the condition, once the diagnosis is confirmed, observation may be indicated.

Unfortunately, Dupuytren’s disease is not curable. Surgery is generally indicated in more severe contractures or when day to day function is impaired. The operation is performed through a combination of zigzag and straight cuts in the palm and fingers. There is often a shortage of skin along the length of the palm or finger. This can be managed with skin grafts or moving flaps of skin locally. Management of Dupuytren’s Contracture continues to be challenging and management by a hand surgeon is recommended.