What is Dupuytren's Contracture?

Dupuytren’s contracture is an abnormal thickening of the tissue under the skin in the palm of your hand at the base of your fingers (fascia). This thickened area may develop into a hard lump or thick band, and over time can cause one or more of the fingers to curl or pull in towards your palm.

Symptoms of Dupuytren's Contracture

The most common symptoms of Dupuytren’s contracture include:

• Not being able to lay your hand flat on a table, palm side down.
• One or more small lumps on the palm.
• Bumps that thicken and contract or tighten.
• Pits or grooves in the skin compressed by the contracted finger.
• Fingers that are pulled forward.
• Abnormal use of the hand.

Causes of Dupuytren's Contracture

Currently, there are no known exact causes of Dupuytren’s contracture. You may be at greater risk if you:

• Smoke or abuse alcohol
• Are older.
• Are male.
• Have diabetes.
• Have nutritional deficiencies.
• Take medicines used to treat seizures.
• Have family history of Dupuytren’s.

Diagnosis and Treatment for Dupuytren's Contracture

Although there is no cure for Dupuytren’s, there are treatments available to help slow the disease or ease your symptoms. Your provider will create a care plan for you based on:

• Your age, overall and past health.
• The severity of your case.
• If your condition is expected to continue to get worse.
• How you handle certain medications or treatments.

Treatments for Dupuytren’s may include:

• Steroid shot – if a lump is painful, a steroid injection may help to ease the pain.
• Radiation therapy – low energy X-rays are directed at the painful nodules to soften them and keep contractions from happening.
• Enzyme injection – enzymes are injected into the lump of tissue. Over several hours, the enzyme breaks down and dissolves the tough bands. This lets the fingers straighten when the cord is snapped by the surgeon the next day.

If these nonsurgical treatments fail to provide adequate relief, or if your fingers are increasingly bent to the palm and you can’t flatten your hand, your provider may recommend surgery in more advanced cases. This may be done when you have limited use of your hand.  During this procedure, your surgeon will make an incision in your hand and cut out the thickened tissue to improve the mobility of your fingers. 

Following surgery, your provider may recommend a splint for a few weeks to help restore the use of the hand and keep symptoms from coming back. They may also recommend physical therapy to gently move your fingers through their normal range of motion and prevent stiffness. 

Risk Factors of Dupuytren's Contracture

It’s important to remember that surgery can improve, but may not completely restore, the use of your hands. Contractures often have a risk of returning, so additional surgery may be needed. Other common risks associated with Dupuytren’s contracture include:

• Bleeding
• Infection
• Delayed wound healing.
• Stiffness, tenderness, or contracture with the fingers still being curled.
• Damage to the skin, caused by trying to surgically separate the skin from tissue.
• Cords retightening