Dupuytren's Contracture

Dupuytren's contracture is a rare hand disorder caused by a thickening of the layer of fibrous tissue beneath the skin of the palm and the finger(s). This thickening causes tendons to tighten (contract), which makes the finger difficult to extend. As a result, the finger is continually "curled up." Although more common in men than women, the cause of Dupuytren's contracture is unknown. However, people who get the condition tend to drink significant amounts of alcohol; have diabetes; smoke; or have seizures similar to those from epilepsy.

Symptoms of Dupuytren's Contracture

The symptoms of Dupuytren's contracture usually come on quite gradually. Symptoms include one or more small nodules that form in the palm. Although tender when they first form, the tenderness often disappears. Nodules can then thicken and contract, forming tough bands of tissue beneath the skin. Eventually, one or more of the fingers may curl toward the palm. Over time, straightening the curled fingers may be difficult, affecting the ability to grasp large objects. Although all fingers can be affected, the two most common are the ring and "pinky" fingers.

Treatment of Dupuytren's Contracture

Dupuytren's contracture cannot be stopped or cured. Because it progresses very slowly, it may not cause problems for years. There is also the chance that, even if nodules form in the palm, they will never progress further. If the condition becomes problematic, both nonsurgical and surgical treatments are available.

Steroid injections are a nonsurgical treatment for the pain caused by nodules. They usually help relieve pain, and may keep the contracture from getting worse. In cases in which fingers are already contracted, XIAFLEX injections, which contain a mixture of enzymes that helps dissolve thickened tissue, may be used. If Dupuytren's contracture continues to get worse, surgery may be recommended.

If Dupuytren's contracture continues to get worse, surgery may be recommended. During surgery, the bands of thickened tissue in the palm are divided or removed to increase finger flexibility. Postsurgery, physical therapy may be required.

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