Understanding Dupuytren's Contracture

A Comprehensive Guide to Diagnosis, Treatment, and Management

Orthopedics

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Last updated: Mar 24, 2025

What is Dupuytren's Contracture?

Dupuytren's contracture is a progressive hand condition that affects the layer of tissue beneath the skin of your palm. This tissue thickens and tightens over time, potentially causing one or more fingers to bend permanently toward your palm.

Key Characteristics

  • Most commonly affects the ring and small fingers
  • Usually develops gradually over years
  • More common in men over 50
  • Often runs in families
  • More prevalent in people of Northern European descent

Common Symptoms

Early Stage

  • Nodules or lumps in the palm
  • Skin dimpling or puckering
  • No pain typically present

Advanced Stage

  • Inability to fully straighten affected fingers
  • Difficulty performing everyday tasks
  • Reduced grip strength
  • "Table-top test" becomes positive

Risk Factors

  • Age (usually appears after 50)
  • Family history
  • Male gender
  • Northern European ancestry
  • Diabetes
  • Smoking
  • Alcohol consumption

Treatment Options

Non-surgical Treatments

  1. Needle Aponeurotomy

    • Minimally invasive procedure
    • Uses a needle to break up tough tissue
  2. Collagenase Injections

    • Enzyme injection to break down contracted tissue
    • Brand name: Xiaflex

Surgical Options

  1. Fasciectomy

    • Removal of affected tissue
    • Most common surgical approach
  2. Dermofasciectomy

    • Removal of affected tissue and skin
    • Skin graft replacement

Recovery and Management

  • Physical therapy often recommended
  • Night splinting may be necessary
  • Regular hand exercises
  • Follow-up care to monitor progression

When to Seek Medical Attention

  • Early nodules appear in palm
  • Difficulty laying hand flat on surface
  • Problems with daily activities
  • Progressive finger bending

Prevention Strategies

  • Regular hand stretching
  • Smoking cessation
  • Limiting alcohol intake
  • Managing underlying conditions

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