Hand & Finger · Palm
Dupuytren's
Contracture
Dupuytren's contracture causes the fingers to develop a flexed posture. The contracture occurs when collagen — a type of glue in our body — is deposited in abnormal quantities, forming the cords and contractures seen in patients with the condition.
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Overview
What Causes the Contracture?
Dupuytren's contracture causes the fingers to develop a flexed posture. The contracture occurs when collagen (a type of glue in our body) is deposited in abnormal quantities.
These depositions, in concert with a specialized cell called a myofibroblast, create the cords and contractures seen in patients with Dupuytren's contracture.
At times, nodules and/or skin pitting may also occur in the hands.
What Patients May Notice
- Cords — thick, rope-like structures felt underlying the skin
- Nodules in the palm of the hand
- Skin pitting
- Fingers that gradually develop a flexed posture
- Difficulty laying the hand flat on a tabletop
- Trouble placing the hand in a pocket or grasping larger objects
When It Interferes With Daily Life
Severe contractures may cause the fingertip to press on the palm of the hand and interfere with hand hygiene. In less extreme cases, patients may still experience interference with daily activities.
For example, some patients are unable to place their hands in their pockets without difficulty, to lay their hands flat on a tabletop, or to open their hands enough to grasp objects such as a football.
Who It May Affect
Dupuytren's contracture may be associated with a family history of the disease. There are some individuals who report a history of diabetes, alcoholism, and/or taking anti-seizure medication.
- Family history of the disease
- Diabetes
- Alcoholism
- Anti-seizure medication use
Discussing your history and symptoms with your treating physician is important when deciding how to proceed.
Treatment Options
From Observation to Surgery
Treatment options include observation, collagenase injection, needle aponeurotomy, surgical fasciotomy, surgical fasciectomy, and a variety of other procedures.
Observation
In mild cases that are not interfering with function, your treating physician may recommend monitoring the condition over time before pursuing treatment.
Collagenase Injection
An injection-based option that is one of the non-surgical treatments available for Dupuytren's contracture.
Needle Aponeurotomy
A procedure that divides the cord using a needle, offered as an alternative to more extensive surgery.
Surgical Fasciotomy
A surgical option that addresses the contracted cord. Your treating physician can discuss whether this approach fits your contracture.
Surgical Fasciectomy
Surgical removal of the affected tissue. As with any hand surgery, outcomes vary and risks and benefits should be discussed in detail with your treating physician.
Other Procedures
A variety of other procedures exist. Discussing your history and symptoms with your treating physician is important when deciding how to proceed.
Recovery After Treatment
Post-surgical treatment may include splinting and exercises to assist with mobilization of stiff fingers and reduction of swelling.
Discussing Your Options
Discussing your history and symptoms with your treating physician is important when deciding how to proceed. The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician.
Outcomes after hand surgery treatments vary and risks and benefits should be discussed in detail with your treating physician. Nonoperative treatment also carries risks and benefits which should be discussed with your treating physician.
Common Questions
Dupuytren's Contracture FAQs
What is Dupuytren's contracture?+
Dupuytren's contracture causes the fingers to develop a flexed posture. The contracture occurs when collagen (a type of glue in our body) is deposited in abnormal quantities. These depositions, in concert with a specialized cell called a myofibroblast, create the cords and contractures seen in patients with Dupuytren's contracture.
What are the cords and nodules in the palm?+
Cords are thick, rope-like structures felt underlying the skin. At times, nodules and/or skin pitting may also occur in the hands.
Is Dupuytren's contracture hereditary?+
Dupuytren's contracture may be associated with a family history of the disease. There are some individuals who report a history of diabetes, alcoholism, and/or taking anti-seizure medication.
How much can the contracture affect daily life?+
Severe contractures may cause the fingertip to press on the palm of the hand and interfere with hand hygiene. In less extreme cases, patients may still experience interference with daily activities — for example, being unable to place their hands in their pockets without difficulty, lay their hands flat on a tabletop, or open their hands enough to grasp objects such as a football.
What treatment options are available?+
Treatment options include observation, collagenase injection, needle aponeurotomy, surgical fasciotomy, surgical fasciectomy, and a variety of other procedures.
What does recovery involve after treatment?+
Post-surgical treatment may include splinting and exercises to assist with mobilization of stiff fingers and reduction of swelling.
Read our article on treatment options for Dupuytren's contracture or learn about trigger finger.
Precision Hand and Orthopedic Surgery
Fingers Curling Toward Your Palm?
An evaluation with Tanay Amin, MD, FAAOS can confirm whether you have Dupuytren's contracture and help you weigh observation, injection, and surgical options based on how much the condition is affecting your daily life.
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Disclaimer: This information is not intended to convey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/10/2021 Tanay Amin, MD. Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.