Dupuytren's Contracture

Overview

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

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

Risk Factors

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

SymptomsandDiagnosis

Symptoms

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

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

Treatments

Treatment

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

There are no known methods to prevent Dupuytren contracture.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

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.