Dupuytren’s Contracture
Dupuytren’s Contracture
What Is Dupuytren’s Contracture?
Dupuytren’s contracture is a condition that affects the palm and fingers. In a healthy hand, fibrous tissue called fascia lies just beneath the skin to help protect nerves, blood vessels, and muscles. In people with this condition, the fascia thickens and forms cord-like bands that pull one or more fingers into a bent position. These cords are not tendons, and they don’t move like muscles do—they are fixed and get tighter over time.
You may also notice small lumps or nodules in the palm, which may stay the same for years or slowly progress. As the disease advances, the fingers—usually the ring and pinky—can become permanently bent, limiting your ability to open your hand.
Causes
The exact cause is unknown, but it tends to run in families and is more common in:
Men over 40
People of Northern European ancestry
Individuals with diabetes, low BMI, or who smoke or drink alcohol
It’s not caused by hand injuries or overuse, although trauma may trigger symptoms in someone already at risk.
Signs & Symptoms
Hard lumps or nodules in the palm
Skin that feels tight, puckered, or thickened
Visible cords extending into fingers
Difficulty straightening fingers or placing the hand flat
Loss of grip strength or difficulty with daily activities like putting on gloves or shaking hands
Treatment Options
Not all cases require treatment. If the hand still functions well and the contracture is mild, observation may be enough. Treatment is usually considered when you can’t lay your hand flat on a table.
Non-Surgical Options
Needle Aponeurotomy: A needle is used to break the cords under the skin. Quick recovery but the cords may return.
Collagenase Injection (Xiaflex®): Enzyme injected into the cord to dissolve it, followed by finger manipulation a few days later.
Both procedures are done in-office, and recovery is typically fast.
Surgical Options
Fasciotomy: Cuts the cord to release tension but doesn’t remove the diseased tissue.
Fasciectomy: Removes cords and nodules, sometimes with skin grafting. This offers better long-term results but involves a longer recovery (about 6 weeks).
After surgery, hand therapy and splinting are essential to maintain motion and prevent stiffness.
