Dupuytren's Contracture

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Dupuytren’s contracture can affect hand function, making daily tasks very difficult to perform. In this article, we will discuss what Dupuytren’s contracture is, what causes it to progress, how it’s diagnosed, and the treatment options available.

Feel free to contact JIS Orthopedics if you have any concerns with your hand or finger movements. Our orthopedic surgeons are helping patients in New Albany and Clairsville, OH. Contact us today!

What is Dupuytren's Contracture?

Dupuytren’s contracture is characterized by the curling of one or more fingers toward the palm of the hand. It occurs as a result of Dupuytren’s disease.

Dupuytren’s disease affects the fibrous layer of tissue on the palm of the hand called the palmar fascia. This tissue is found under the skin but above the tendons, bones, blood vessels, and nerves. The condition causes the fascia to thicken and shorten over time. This may pull the fingers, causing them to stick in a bent position.

What Causes Dupuytren's Contracture?

Dupuytren’s contracture is an inherited genetic condition which effects a particular type of collagen in your tissues creating the potential for contracture to occur.

Risk Factors for Dupeytren's Disease

The associated risk factors that contribute toward the developing or worsening of Dupuytren’s disease include the following:

Your age: Dupuytren’s disease usually develops around middle age.
Your gender: Men are more likely to develop the condition.
Your ancestry: You are more likely to develop the condition if you are of Scandinavian or northern European descent.
Family history: Dupuytren’s disease tends to run in families.
Alcohol use: Drinking alcohol can worsen the condition.
Other medical conditions: If you suffer from seizure disorders or diabetes, you’re more likely to develop the condition.
Trauma: Trauma to the hand, including hand surgery, can worsen the condition.

Symptoms of Dupuytren's Contracture

You will normally notice a Dupuytren’s contracture worsening very slowly for years. The signs and symptoms of Dupuytren’s contracture may include:

Small Lumps: Small lumps, or nodules, may develop in the palm of your hand.
Thick Cords: The small lumps or nodules may thicken and contract. They can eventually develop into tough, dense cords under the skin. These cords can begin to affect finger movement.
Contractures: Contractures occur as tissue under the skin tightens. You may notice one or more of your fingers pulling toward your palm. The most common fingers to be affected are the ring and little (pinky) finger, although any can be affected, including the thumb.

How is Dupuytren's Disease Diagnosed?

Your doctor will begin by considering your medical and family history. They will then perform a physical exam and check the current condition of your fingers and hand.

Your doctor will then examine your fingers and hand. During the exam, they will likely:

Check the location of nodules and cords on your hand
Measure the range of motion of your fingers and thumb
Check the sensitivity of your fingers and thumb

They will register these measurements to evaluate how the condition progresses over time.

How is Wrist Rheumatoid Arthritis Diagnosed?

To diagnose wrist rheumatoid arthritis, a comprehensive evaluation is required. Your healthcare provider will consider your medical history, perform a physical examination, and order specific tests. Blood tests, such as rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibody tests, can help in confirming the diagnosis.

Dupuytren's Contracture Treatments

Although there is no cure for Dupuytren’s disease, treatments can be provided to slow the disease down. This includes both non-surgical and surgical options, which are described below.

Non-Surgical Treatment Options

Your doctor will usually begin to treat Dupuytren’s disease with non-surgical treatments. Non-surgical treatments for Dupuytren’s disease include the following:

Steroid Injection: Corticosteroids can be injected into a painful node to help reduce inflammation.
Collagenase injection: Collagenases break down the collagen in a Dupuytren’s cord. The enzymes will not break down the collagen in other structures of the hand because the collagen is different. These injections can improve the range of motion in the fingers or thumb. This is a good option for those who cannot have or do not want surgery.
Needle aponeurotomy: Your surgeon will use a needle to cut through the cord. This allows for improved finger motion.

Surgical Treatment Options

Surgical treatment may be recommended if the contracture interferes with hand function. Surgery can help improve the range of motion in the affected fingers. The procedures work by disrupting or removing the cords. Although there is a potential for the cords to return, many patients experience significant gains in hand function.

Surgical procedures for Dupuytren’s contracture include the following:

Fasciotomy

In fasciotomy, your surgeon will make incisions to divide the thickened tissue. During recovery, your affected finger will be put into a splint to keep your finger(s) straight. As the diseased tissue is not removed, the contracture is more likely to return than in partial palmar fasciectomy.

Partial Palmar Fasciectomy

This surgical procedure is more extensive than fasciotomy. Your surgeon will make “zig-zag” incisions and remove as much of the diseased tissue as possible. They will likely cover the wound with a skin graft to aid the healing process.

Physical therapy sessions and recovery time will be longer than for those who have the fasciotomy procedure—however, the chances of recurrence are lower.

Book Your Appointment Today

At JIS Orthopedics, our orthopedic surgeons are expertly trained to treat several hand conditions. If you are looking for expert treatment tailored to your specific needs, give us a call today! We have practices in New Albany and St. Clairsville, Ohio.

Medically reviewed by AJ Julka, MD

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