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Dupuytren Contracture

Pronounced: du-pwe-trahn kon-trak-choor

 

Definition

Dupuytren contracture is a thickening and tightening of the tissue in the palm and fingers. It causes one or more fingers to be curled in toward the palm.

Dupuytren Contracture Scarring

Nucleus factsheet image

Copyright © Nucleus Medical Media, Inc.

 

Causes    TOP

The exact cause is not known. It may be due to genetics and the environment.

 

Risk Factors    TOP

It is more common in people of Northern European descent. It is also more common in men and people over 40 years of age. Other things that may raise the risk are:

  • Having a family member who has it
  • Alcohol use disorder
  • Smoking
  • Manual labor
  • Vibration exposure at work
  • Cancer
  • Diabetes
  • Low body weight
 

Symptoms    TOP

The main problem is not being able to straighten the finger. The ring finger is usually affected first. The pinky finger is often second. The index, and long finger may follow. This does not cause pain in most people. Other problems may be:

  • A bump in the palm near the bottom of a finger
  • Skin on the palm that looks pitted, thick, or dimpled
  • Loss of grip strength
 

Diagnosis    TOP

The doctor will ask about your symptoms and health history. A hand exam will be done.

 

Treatment    TOP

There is no cure. Treatment may not be needed in people who are still able to use their fingers. Other people may need:

Medication

Medicine may be injected into the area. It may be:

  • Corticosteroids to slow the disease and ease pain and swelling
  • Collagenase clostridium histolyticum to break down the thickened tissue

Surgery

Some people may need surgery when initial care does not help or the problem is severe. Surgery may break up or remove the thickened tissue. This may help straighten the finger and help it to move. The problem may come back and surgery may need to be repeated.

A splint will need to be worn after surgery. Exercises will also need to help with strength and movement.

 

Prevention    TOP

There are no known methods to prevent Dupuytren contracture.

RESOURCES:

American Society for Surgery of the Hand
http://www.assh.org

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

Canadian Centre for Occupational Health and Safety
http://www.ccohs.ca

Health Canada
https://www.canada.ca

REFERENCES:

Badalamente MA, Hurst LC, et al. Efficacy and safety of collagenase Clostridium Histolyticum in the treatment of proximal interphalangeal joints in Dupuytren contracture: Combined analysis of 4 phase 3 clinical trials. J Hand Surg. 2015;5:975-983.

Degreef I, Tejpar S, et al. High-dosage Tamoxifen as neo adjuvant treatment in minimally invasive surgery for Dupuytren Disease in patients with strong pre disposition toward fibrosis. J Bone Joint Surg Am. 2014;96(8):655-662.

Dupuytren disease. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T114104/Dupuytren-disease . Updated February 8, 2017. Accessed September 7, 2017.

Lanting R, Broekstra DC, Werker PMN, van den Heuvel ER. A systematic review and meta-analysis on the prevalence of Dupuytren Disease in the general population of Western countries. Plast Reconstr Surg. 2014;133(3):593-603.

Riester S, vanWijnen A, Rizzo M, Kakar S. Pathogenesis and treatment of Dupuytren disease. J Bone Joint Surg Reviews. 2014;2(4):e2.



Last reviewed September 2019 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 9/23/2019

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