Dupuytren's contracture

Causes and Risks:
The cause of the contracture is unknown, but minor trauma and genetic predisposition may play a role. One or both hands may be affected. The ring finger is affected most often followed by the little, middle, and index fingers. A small, painless nodule develops in the connective tissue and eventually develops into a cord-like band. Extension of the fingers becomes difficult to impossible with advanced cases. The incidence increases after the age of 40, and men are affected more often than women. Risk factors are alcoholism , epilepsy , pulmonary tuberculosis , diabetes , and liver disease .

Prevention:
Awareness of risk factors may allow early detection and treatment.

Symptoms:
  • painless nodule in the palm, developing into a cord-like band
  • thickening of the lines in the palms of the hands (linear palmar thickening)
  • extension of the fingers is difficult
    • the 4th and 5th fingers curl up and are unable to be easily straightened ( contracture )



Signs and Tests:
A physical examination of the palm by touch ( palpation ) confirms the presence of the contracture .

Treatment:
Exercises, warm water baths, or splints may be helpful. The progression of the contracture is monitored. Surgery may be performed to release the contracture, depending on the severity of the condition. Normal movement of the fingers is usually restored by surgery followed by physical therapy exercises for the hand.

Prognosis:
The disorder progresses at an unpredictable rate. Surgical treatment can usually restore normal movement to the fingers.

Complications:

  • inability to use the hand



Call Your Healthcare Provider:
Call your health care provider if symptoms indicate you may have this disorder.