Dupuytren's Contracture

What is Dupuytren's contracture?

Dupuytren's contracture is a condition in which thickened tissue in the hand forces one or more of your fingers to bend toward the palm.

How does it occur?

The cause of Dupuytren's contracture is not known. In most cases it does not start until after age 40. It tends to be more common in men and in people who have other family members with it. It is also more common in northern Europeans. Alcoholics, diabetics, smokers, and people who are taking anticonvulsant medicine for seizures seem to have a greater risk for this problem. You can get it in 1 or both hands.

What are the symptoms?

A thickening, or nodule, develops in the palm of the hand near the base of the ring or little finger. Sometimes a pit, or indentation, may form in the palm or on the finger. Other nodules may develop and create a cord, or band, that extends from the palm into the finger. This cord tightens and pulls the finger into a bent position toward the palm causing some discomfort. It becomes hard to straighten the finger. The thickened tissue may pull the finger into a completely bent position. It may even get so bad that you cannot use your fingers.

Any of the fingers may be affected, but it is most common in the ring finger or little finger. Pain is not common with Dupuytren's.

If the condition gets worse quickly, the fingers can become bent within a few weeks or months. But this is rare. It is more common for a finger to take several years to reach the bent position.

How is it treated?

Dupuytren's contracture can be treated with a steroid shot. In the early stage of the problem this can prevent or slow the thickening and stiffening of the tissues.

Different kinds of surgery can be done for Dupuytren's contracture.

• The least invasive uses a needle to break up the stiff, contracting tissues. After local anesthesia is given to numb the area, a needle is used to go through the skin and tear the attachments of the tissues that are causing the finger to bend.
• Surgery called Dupuytren's contracture release involves cutting and removing the thickened tissue in the hand.

Surgery is usually suggested only if you have pain or discomfort that is extreme or if you cannot use your hand. Your healthcare provider may suggest surgery if it is impossible to place your hand flat on a table.

If you have surgery, you should not use your hand for several weeks after the procedure. You may have to wear a bulky dressing, cast, or splint for a while. You will likely have physical therapy for 1 to 2 months after surgery.

How long will the effects last?

The disease may worsen very slowly and but it will not go away. Your healthcare provider will want to see you about every 6 months to check for worsening of the problem. Your provider can then suggest surgery if and when it becomes necessary.

The results of surgery are usually good. You may regain full use of your fingers and hand. However, Dupuytren's can come back after either treatment--shot or surgery--sometimes soon, sometimes many years later.

How can I help prevent Dupuytren's contracture?

There is no way to prevent Dupuytren's. However, not smoking and having a healthy lifestyle helps to prevent conditions that may be a factor in developing Dupuytren's, such as diabetes or alcoholism.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File orre3256.htm Release 13/2010