Dupuytren's Contracture

Dupuytren's contracture is a painless condition in which thick, scar-like tissue forms under the skin of the palm. Sometimes this tissue extends into the fingers, generally the ring and pinky fingers, pulling them toward the palm causing the fingers to curl. This can make the fingers difficult to move. The condition usually progresses slowly over a period of years but can occur within a matter of months or even weeks.



As Dupuytren's contracture progresses, patients often notice a thickening of the tissue under the skin of their palm. The skin of the palm may also appear puckered or dimpled. Other symptoms include:

  • A small, painless lump in the palm of the hand. While painless, these lumps can be tender to the touch.
  • Curled fingers that are unable to straighten. The ring and pinky fingers are most often affected.

The fingers begin to curl as the condition progresses and are a symptom during later stages.



To diagnose Dupuytren's contracture, a doctor will perform a physical examination and discuss the symptoms. The physician will look for thickening of the tissue and puckering of the skin on the palm of the hand. The physical exam may also include manually probing and feeling the stiff tissues around the palm to detect any toughened areas.



There is no way to stop the progress of Dupuytren's contracture, however, the condition is not dangerous. Because the condition is not dangerous to a patient's health, non-surgical treatments that focus on slowing the progression of the condition may be the best treatment options. This may include lifestyle changes or steroid injections to reduce inflammation.

If the condition progresses to the point that it interferes with a patient's daily life, more aggressive treatment may be needed. Less-invasive techniques focus on breaking down the thick tissue bands while other surgical methods focus on dividing or removing the thick band of tissue that is impeding the fingers ability to straighten.

One option is a less-invasive technique known as needling. During this procedure, a needle is inserted through the hand and used to break up the thickened tissue. The contracture can recur; however, this procedure can be repeated. Other limited-invasive options include enzyme injections which soften the tissue band, allowing the physician to manually breakdown the band by manipulating the patient's hand.

If surgery is needed, the affected tissue will be removed from the hand. This method is more invasive and can be more difficult because the tissue may be attached to the skin. However, the release of the affected joint is more complete than the less-invasive methods. Physical therapy and a longer recovery time are often needed after surgery.

The knowledgeable and highly trained staff at the Hand Surgery Program will work with each patient to determine the best treatment option.

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