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Definition

What is Dupuytren’s contracture?

Dupuytren’s contracture is a disease that causes nodules, or knots, to build up underneath the skin of your fingers and palms. It can cause your fingers to become stuck in place. It most commonly affects the ring and little fingers and causes the proximal and middle joints, which are those closest to your palm, to become bent and difficult to straighten. Treatment of this condition varies depending on the severity of the nodules.

How common is Dupuytren’s contracture?

If you are between the ages of 40 and 60, you may have a higher risk of developing Dupuytren’s contracture’s tenosynovitis than do other age groups. The condition is more common in men. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Dupuytren’s contracture?

It is found that Dupuytren’s contracture typically progresses slowly, over years. The condition usually starts as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled. A firm lump of tissue can form on your palm. This lump might be sensitive to the touch but usually isn’t painful. In the later stages of Dupuytren’s contracture, cords of tissue form under the skin on your palm and can extend up to your fingers. As these cords tighten, your fingers might be pulled toward your palm, sometimes severely.

The ring finger and pinky are most commonly affected, though the middle finger also can be involved. Only rarely are the thumb and index finger affected. Dupuytren’s contracture can occur in both hands, though one hand is usually affected more severely.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Dupuytren’s contracture?

Until now doctors don’t know what exactly causes Dupuytren’s contracture. There’s no evidence that hand injuries or occupations that involve vibrations to the hands cause the condition.

Risk factors

What increases my risk for Dupuytren’s contracture?

Although the cause of this disease is still unknown, your risk of developing the condition increases if you:

  • Are male
  • Are between 40 and 60 years of age
  • Are of Northern European descent
  • Have a family history of the condition
  • Smoke or drink alcohol
  • Have diabetes

You should notice that overuse of your hands, such as from working in a job that requires repetitive hand motions, and hand injuries don’t increase your risk of developing this condition.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Dupuytren’s contracture diagnosed?

If your doctor suspects that you may experience this condition, a physical examination will be performed and some tests will be also recommended by your doctor. In most cases, doctors can diagnose Dupuytren’s contracture by the look and feel of your hands. Your doctor will compare your hands to each other and check for puckering on the skin of your palms. He or she will also press on parts of your hands and fingers to check for toughened knots or bands of tissue.

Your doctor also might check to see if you can put your hand flat on a tabletop or other flat surface. Not being able to fully flatten your fingers indicates you have Dupuytren’s contracture.

How is Dupuytren’s contracture treated?

Unfortunately, there’s no cure for Dupuytren’s contracture, but there are treatments available. You may not need any treatment until you’re unable to use your hands for everyday tasks. Nonsurgical treatments are available, including steroid injection, which can prevent progression of the contracture, and splinting.

In some more severe or progressed cases, your doctor may recommend surgery. Surgical treatment involves breaking up the cords that are pulling your fingers in. The severity of your condition will determine the best course of treatment:

Needling

Needling involves using a needle to break the cords apart. The contracture often comes back, but the procedure can be repeated.

The advantages are that needling can be done multiple times and it has very short recovery time. The disadvantage is that it can’t be used on every contracture because the needle could damage nearby nerves.

Enzyme Injections

Xiaflex, an injectable collagenase injection, weakens the cords. Your doctor will manipulate your hand to try to break up the cord the day after the injections are given. This is an outpatient procedure with a short recovery time.

The disadvantages are that it can be used on only one joint each time and there’s a high recurrence of the fibrous bands. The treatments must be at least one month apart.

Surgery

Surgery removes the cord tissue, but it may need to be done at a later stage when the cord tissue is identifiable. On occasion, it may be hard to remove the cord without removing the attached skin.

The disadvantages of surgery are that it has a long recovery period and requires physical therapy to return full hand movement and functionality. On rare occasions, skin tissue may also be removed during the surgery, which requires a skin graft to cover the area.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Dupuytren’s contracture?

The following lifestyles and home remedies might help you cope with this condition:

  • Avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape
  • Using gloves with heavy padding during heavy grasping tasks

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 31, 2017 | Last Modified: July 31, 2017

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