What is Dupuytren's Contracture?

Dupuytren's contracture is a relatively painless hand deformity in which fibrous tissue under the skin of the palm thickens and tightens slowly over time, causing one or more fingers to curl inward toward the palm. Although both hands can be affected, the condition usually impacts just one hand. Dupuytren's contracture mainly affects the ring finger and pinky finger, but on rare occasion may involve the index finger or the thumb. In advanced cases, Dupuytren's contracture can make it difficult, if not impossible, to perform simple activities such as shaking hands. 

Baptist Health is known for advanced, superior care for patients with orthopedic conditions and the diagnosis, treatment and management of Dupuytren's contracture. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of Dupuytren's specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Dupuytren's Contracture Signs and Symptoms

Signs and symptoms of Dupuytren's contracture in a hand can include:

• Small, tender nodules (lumps) that appear on the palm of the hand
• A thickening of the skin of the palm
• The skin of the palm may appear puckered or dimpled

Diagnosis

If Dupuytren's contracture is suspected, we perform a physical examination and ask questions about symptoms. Because the diagnosis of Dupuytren's contracture is made by the look and feel of the affected hand, other diagnostic tests are rarely necessary.

Causes

The exact cause of Dupuytren's contracture is unknown. However, current evidence does seem to indicate Dupuytren's Contracture is hereditary. 

Risk Factors

Risk factors that can contribute to Dupuytren's contracture include:

Gender: Men are three times more likely to develop Dupuytren's contracture than women. Women who are diagnosed with this condition tend to get it much later in life and experience milder symptoms.

Heredity: The condition tends to run in families.

Age: The condition is associated with those 40 years of age and older.

Ancestry: People of Northern European (English, Irish, Scottish, French or Dutch) or Scandinavian (Swedish, Norwegian or Finnish) descent are at higher risk of the condition.

Certain medical conditions: For unknown reasons, the condition is associated with those who have diabetes or a seizure disorder, such as epilepsy.

Hand trauma: Although not a causal factor, higher rates of Dupuytren's contracture are observed in those who have experienced hand trauma.

Smoking: Smoking is linked to Dupuytren’s contracture.

Excessive alcohol consumption: Regular, heavy alcohol consumption increases the risk for Dupuytren’s contracture.

Prevention

While many risk factors cannot be controlled, learn how to prevent Dupuytren's contracture in these ways:

Reduce alcohol consumption: There is a connection between increased risk of Dupuytren's Contracture and alcoholism.

Stop smoking: It is believed that smoking is associated with increased risk of developing Dupuytren's contracture because smoking creates microscopic changes within blood vessels in the hands, as well as throughout the body.

Prognosis

The prognosis for people with Dupuytren's contracture depends upon the patient’s outlook on the condition. It is not life threatening and treatment can temporarily improve some mobility. Also, Dupuytren's contracture is relatively painless (although nodules can be sensitive to touch), and the condition progresses slowly over many years. There is, however, no cure for the disease.

Treatment and Recovery

The main treatments for Dupuytren's contracture are:

Nonsurgical

Nonsurgical treatment may help to slow the disease progression. Nonsurgical options include steroid and enzyme injections, needling (a technique where needle punctures are used to break up the fibrous cord of tissue under the skin) and splinting (which does not prevent increased beading in the finger).

Surgery

Surgery is an option for patients who can no longer perform everyday tasks such as putting on gloves or placing their hands in their pockets, and offers the best possibility of longer-term flexibility. Surgery divides or removes the thickened bands under the palm skin to help restore finger mobility. Skin grafting may be needed to heal the resulting wound.

Complications

Complications of Dupuytren's contracture may include:

Reduced freedom of hand movement: Dupuytren's contracture can limit one’s ability to fully open the affected hand, grasp large objects or maneuver the hand into narrow places. The ability to perform day-to-day tasks, such as washing dishes or grasping tools, can be decreased. Fortunately, because the condition rarely impacts the forefinger or thumb, fine motor skills such as writing is rarely disabled.

Reoccurrence: Since there is no cure for Dupuytren's contracture, about 20 percent of patients who undergo surgery for the condition will require another surgery to restore hand movement.