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 the disease in the 1600s, great advances have been made in understanding Dupuytren's contracture. It is thought to be a hereditary disease, but the exact cause is unknown and there are still some unanswered questions about the disease. Dupuytren’s contracture may be associated with cigarette smoking, epilepsy, diabetes and alcoholism, and usually presents in middle age. The ring finger is the most commonly affected finger, and the little finger is the second-most commonly affected finger. Of the total cases of Dupuytren’s contracture, 33% involve only one finger, 33% involve two fingers, and the remaining 33% involve more than two fingers.
Though each individual may experience symptoms differently, and some symptoms may resemble other medical conditions or problems, the most common symptoms of Dupuytren’s contracture include: thick tissue that develops under the skin in the palm of the hand, finger(s) that are pulled forward, and a decrease in hand function.
We will work with you to determine a specific treatment plan that’s right for you based on the following factors:
- 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
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. During the surgery, we will make an incision in the hand and cut the area of thickened tissue. This allows for improved movement of the tendons and increased finger mobility.
Surgery for Dupuytren’s contracture is a very precise procedure because this thickened area of tissue often contains the nerves of the hand. Skin grafts are sometimes needed to correct the overlying skin and 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. Following surgery, you will need physical therapy to help increase the strength and function of your affected hand.