Dupuytren's contracture, also called Dupuytren's disease, usually begins with a thickening of the skin in the palm of the hand, which may develop into a hard lump or thick band that eventually could cause the fingers to contract, or pull into the palm.
Since the first recording of this disease in the 1600s, great advances have been made in understanding this disease, although, there are still some unanswered questions. It is thought to be a hereditary disease, which means it is inherited from the family, but the exact cause is unknown. Dupuytren's contracture may be associated with cigarette smoking, epilepsy, diabetes, and alcoholism, and usually presents in middle age.
Consider the following statistics related to Dupuytren's contracture:
- The ring finger is the most commonly affected finger.
- The little finger is the second most commonly affected finger.
- One, two, or more fingers may be affected.
- Men are affected more often than women.
The following are the most common symptoms of Dupuytren's contracture. However, each individual may experience symptoms differently. Symptoms may include:
- development of thick tissue under the skin in the palm of the hand
- finger(s) are pulled forward
- decrease in hand function
The symptoms of Dupuytren's contracture may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
Specific treatment for Dupuytren's contracture will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
At the present time, surgery is the only treatment available to help correct advanced Dupuytren's contracture. While surgery may increase the mobility of the finger(s), it does not correct the underlying disease process.
During the surgery, the surgeon makes an incision in the hand and cuts the area of thickened tissue. This allows for improved movement of the tendons and increases finger mobility. It is a very precise surgery because the nerves in the hand are often in this area of thickened tissue. Sometimes, skin grafts are needed to correct the overlying skin. This involves replacing or attaching skin to a part of the hand that is missing skin. Skin grafts are performed by taking a piece of healthy skin from another area of the body (called the donor site) and attaching it to the needed area.
After surgery, physical therapy for the affected hand will be implemented to help increase strength and function.