Dupuytren’s disease or Dupuytren’s contracture is a fairly common condition. It is a thickening of the connective tissue, or fascia, of the palm and fingers. It usually starts with a tiny nodule in the palm that can appear to be a blister or callous. Over time cords develop beneath the skin, and the affected fingers are pulled towards the palm and can’t be straightened.
Sufferers of Dupuytren’s Disease usually experience solid lumps and pits within the palm, with thick cords developing from the palm towards the fingers (most commonly the ring and small fingers). Most often both hands will be affected, albeit it may be in different ways. These lumps can cause discomfort and at time can be painful but the pain usually subsides.
Sufferers may notice the condition when they have difficulty placing the hand flat as fingers are pulled towards the palm. Difficulty can arise when trying to wash hands, putting on gloves, shaking hands or even putting your hands in your pocket. The younger the patient, the more severe the symptoms tend to be.
The cause is unknown, but evidence suggests that it is a genetic condition that commonly occurs in northern European men over 40.
Where the symptoms are mild, we would usually advise conservative management, as it doesn’t necessarily mean that the symptoms will get worse. However, for more severe cases there are various treatments available to help straighten the fingers. These include injectable medicine or surgery to improve finger motion or function, with splinting and hand therapy needed after treatment to maintain improved finger function. The treatment given will depend on the pattern of the disease and joints affected. Even with surgery, a complete correction of the fingers may not always be possible, and the disease can reoccur. However, we will discuss the realistic outcome and possible risks with you.