Dupuytren’s Contracture

What is Dupuytren’s contracture?

Dupuytren’s contracture is a genetic disorder that causes lumps and cords of abnormal scar tissue to form in the palms and fingers. As this scar tissue gradually contracts, it causes drawing in (contractures) of the fingers.

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In people with Dupuytren’s contracture, the abnormal tissue gradually stiffens the palm, limiting flexibility and making it harder to fully straighten the affected fingers.

How Dupuytren’s affects the hand

The hands are made up of small joints, muscles and connective tissues that work together to allow precise movement. In people with Dupuytren’s contracture, the abnormal tissue gradually stiffens the palm, limiting flexibility and making it harder to fully straighten the affected fingers.

Overview

Symptoms

Signs and symptoms may include:

Gradually growing lumps or cords in the palm or fingers
Lumps that may or may not be tender; pain is usually minimal
Fingers gradually bending (contracture), most often the small and ring fingers
Similar tissue changes in the feet or genitals in some patient

Causes

The cause is thought to be genetic, although it may not be present in every family member and may skip generations. Dupuytren’s contracture is more common in people of northern European descent. Hand or finger injuries — including surgery — may trigger or accelerate the condition, but they are rarely the root cause.

Diagnosis

Why treatment matters

There is no cure for Dupuytren’s contracture, but there are some effective treatments. Treatment recommendations depend on the severity and location of the contracture as well as your activity level and preferences.

Nonoperative treatments

The best treatment for minor contractures is simple observation. Splinting and hand therapy generally are not effective in preventing progression. In some cases, a steroid injection may help reduce pain associated with tender lumps. Moderate contractures may be a candidate for an injection treatment called Xiaflex. This is an enzyme that is injected into the abnormal cord of scar tissue to weaken it, followed by a minor office procedure to numb the area and stretch the weakened cord until it ruptures, and the finger straightens.

Operative treatments

In cases of moderate to severe contracture where the hand can no longer push flat against a tabletop, we recommend surgery to remove the abnormal cords of scar tissue. This procedure is called a partial fasciectomy. Even with surgical removal of the Dupuytren’s cords, they can recur over time.

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Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.