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Dupuytren’s contracture (also known as “Morbus Dupuytren,” “Dupuytren’s disease,” or “Palmar fibromatosis”[1], and sometimes misspelled as Dupuytren’s constricture) is a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended (straightened). It is named after Baron Guillaume Dupuytren, the surgeon who described an operation to correct the affliction.
The ring finger and little finger are the fingers most commonly affected. The middle finger may be affected in advanced cases, but the index finger and the thumb are nearly always spared. Dupuytren’s contracture progresses slowly and is usually painless. In patients with this condition, the tissues under the skin on the palm of the hand thicken and shorten so that the tendons connected to the fingers cannot move freely. The palmar aponeurosis becomes hyperplastic and undergoes contracture.
Incidence increases after the of 40; at this age men are affected more often than women. After the age of 80 the distribution is about even.
In Dupuytren’s disease, the tough connective tissue within one’s hand becomes abnormally thick which can cause the fingers to curl and can result in impaired function of the fingers, especially the small and ring fingers. It usually has a gradual onset, often beginning as a tender lump in the palm. Over time, pain associated with the condition tends to go away, but tough bands of tissue may develop. [1] These bands, which are the source of the reduced mobility commonly associated with the condition, are visible on the surface of the palm and may appear similar to a small callus. It commonly develops in both hands and has no connection to dominant or non-dominant hands, nor any correlation with right- or left-handedness.
The contracture sets in slowly, especially in women. However, when present in both hands and when there is associated foot involvement, it tends to progress more rapidly.
Dupuytren’s disease is a very specific affliction, and primarily affects:
Some suspected, but unproven causes of Dupuytren’s contracture include trauma, diabetes, alcoholism, epilepsy and liver disease. There is no proven evidence that hand injuries or specific occupational exposures lead to a higher risk of developing Dupuytren’s disease although there is some speculation that Dupuytren’s may be caused or at least the onset may be triggered by physical trauma, such as manual labor or other over-exertion of the hands. However, the fact that Dupuytren’s is not connected with handedness casts some doubt on this claim.[2]
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