Dupuytren’s contracture (Dupuytren's disease) is a condition that affects the hands and fingers. It causes one or more fingers to bend into the palm of the hand. It can affect one or both hands, and sometimes affect the thumb.

Dupuytren's contracture occurs when the connective tissue in the palm thickens. Often the tissue thickens in one small area first and a “nodule” forms (a small, hard lump about 0.5-1cm) under the skin of the palm.

The nodules are non-cancerous (benign) and the condition isn't life-threatening for those who develop it, although it can be a nuisance to live with.

Over time, the nodules can extend and form cords of tissue. These cords can shorten (contract) and, if the cords run along a finger or thumb, they can pull it, so it becomes bent towards the palm. These contractures are often mild and painless, but they can get steadily worse over time.

Symptoms
Over time, usually months or years, bands of contracted (shortened) tissue called cords can develop in your hand and you may find you can't straighten your fingers as much as you used to be able to.

The ring finger is most commonly affected by Dupuytren's contracture, followed by the little finger and then the middle finger. In rare cases, the condition also affects the toes and the soles of the feet.

The condition can affect one or both hands. In cases where only one hand is affected, problems usually develop in the right hand, regardless of whether you're left- or right-handed.

As Dupuytren's contracture progresses, your fingers may eventually be pulled into a permanently bent position. This can make it difficult to perform activities such as swimming, playing a guitar or shaking someone's hand.

Treatment
The treatment used largely depends on the severity of the condition. In milder cases that require treatment, non-surgical treatments or a minor procedure called a needle fasciotomy may be recommended.

For more severe cases, surgery is an effective and widely used treatment. The two most common surgical procedures are an open fasciotomy and a fasciectomy.

dupuytren2

* Patient consent was obtained for publication of figures