Understanding Dupuytren Contracture
Dupuytren contracture is a disease that occurs when the fibrous tissue beneath the skin of the palm and fingers thickens. This tissue is called the palmar fascia. If the disease gets worse, it can cause small hard knots (nodules) to form under the skin. Hard bands (cords) of tissue can also form. Over time, your fingers may curl and bend toward the palm. This effect is called contracture. This can make it hard to straighten your fingers.
What causes Dupuytren contracture?
Doctors don’t know the exact cause of Dupuytren contracture. It may run in families, especially those of Northern European descent. The disease is more common in adults older than 50. It is also more common in men than in women.
Symptoms of Dupuytren contracture
Symptoms for Dupuytren contracture tend to occur slowly. They may include:
Pitted, dimpled, or “puckered” skin over the palm
Hard lumps that form on the palm. Sometimes, the lumps are tender at first.
Scar-like bands that form across the palm
Fingers that bend toward the palm. The ring and little fingers are most often affected.
You are not able to place the palm flat on a surface
You have trouble holding or grasping objects
Hand pain (less common)
Treating Dupuytren contracture
Treatment for Dupuytren contracture depends on how serious your symptoms are. Treatment can’t cure the disease. But it can help reduce symptoms or make it easier to move your fingers. Treatments may include:
Shots of medicine. These usually consist of corticosteroids (a powerful anti-inflammatory medication) they may help relieve symptoms and reduce the size of nodules.
Enzyme shots. These may be used to break up the thickened tissue. This helps reduce contracture. It may allow your fingers to straighten again.
Needle aponeurotomy. Shallow needle punctures are made through the skin to break up the thickened issue. This helps reduce contracture. It may allow your fingers to straighten again.
Hand exercises. These are often prescribed along with other treatments. They may help stretch and improve the range of motion in the hand and fingers.
Surgery. Various surgical techniques may be used to remove some of the thickened tissue in the palm. This helps reduce contracture. It also improves normal finger motion and hand function.
Possible complications of Dupuytren contracture
In some people, the contracture in the hand may get worse over time. This can lead to joint stiffness, deformity, and reduced function of the hand.
When to call your healthcare provider
Call your healthcare provider right away if you have any of these:
Fever of 100.4°F (38°C) or higher, chills, oras directed
Symptoms that don’t get better with treatment, or get worse
March 15, 2019
Aggarwal R, et al. Dupuytren's contracture. Up To Date. August ed: Up To Date; 2015. p. 7., Ferri F. Dupuytren's Contracture. In: Ferri F, editor. Ferri's Clinical Advisor 2016. Philadelphia: Elsevier; 2016. p. 436., Hurst L. Dupuytren's Contracture. In: Wolfe SW, et al, editors. Green's Operative Hand Surgery. Philadephia: Churchill; 2011. p. 141-58., Watt AJ. Management of Dupuytren's disease. In: Neilgan PC, et al, editors. Plastic Surgery. 3 ed. Philadelphia: Elsevier; 2013. p. 346-62.
Raymond Kent Turley BSN MSN RN ,Kenny Turley PA-C