Dupuytren's contracture (contracted palmar fascia)

Description Dupuytren's con...

Description

Dupuytren's contracture is a soft tissue condition that causes a slowly progressive deformity of the hand. The cause is unknown, but is thought to be an inherited disorder and is seen more frequently with increasing age. The condition is more common in men than in women and in people of Northern European heritage. Thick tissue forms under the skin and impedes the movement of the tendons in the hand. This causes the hand to flex and contract causing decreased function of the affected hand. Over time, the fingers bend towards the palm and cannot be straightened. The ring and little finger are most commonly affected while the index finger and thumb are usually spared.

Symptoms

Symptoms include bumps or nodules in the palm of the hand, decreased range of motion of the hand and a loss of dexterity. Dupuytren's contracture progresses slowly and is usually painless. The condition has not been associated with an injury or repetitive hand use.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical will be performed. A doctor can often make the diagnosis based on exam findings alone.

Tests:
X-ray, Fasting blood sugar

Specialists:
Internal Medicine, Hand Surgery, Plastic Surgery, Family Practice, Orthopedic Hand Surgery

Treatment

Treatment depends on the stage of the disease. Initial therapy may be primarily performed by a physical therapist with a combination of stretching, splinting, massage and therapeutic modalities. Corticosteroid injections may also be performed but are associated with skin discoloration and atrophy of the fat in the hand. An injection of collagenase into the soft tissue of the affected fingers, followed by soft tissue manipulation has shown favorable results for early to mid-progression of the contracture. Surgery to release or remove scar tissue may be considered for advanced cases.