Dupuytren Contracture: Diagnosis and Treatment
Dupuytren contracture is a disease of the tissue located under the skin of the palm, called subcutaneous tissue.
In this disease the subcutaneous tissue becomes fibrous (tough and resilient) and begins to contract, pulling the fingers into a abnormal position and restricting their movement (extension).
Before reading further please see the Hand Anatomy to get a better understanding (skip if you have already done so).
Dupuytren contracture occurs
- more between the age of 50 to 70 years
- 10 times more in men than women
- more in people of Scandinavian and Celtic origin
- more in people with diabetes and epilepsy
- in both hands in 40% of patients
- equally in the dominant and non-dominant hand
The disease usually starts in the area of the palm below the ring finger and continues to involve the ring and little fingers. The joints
of the fingers gradually develop contractures. Nodules and cords can be felt below the skin. Mild pain and itching may be present.
is seen when
- there is a positive family history (other relatives have the disease)
- the diseased is a male
- there is involvement of both hands
- the diseased is a alcoholic, diabetic or epileptic
- the progression of the disease is rapid (deformity develops within a few years of onset)
Diagnosis is by history and physical examination. Investigations are rarely required. Your doctor may order a blood glucose test
to rule out diabetes.
is indicated when contractures in the fingers interfere with activities of daily living
. In the absence of contractures no
treatment is usually required.
Treatment is by surgery. Surgical procedures used are
- Subcutaneous fasciotomy (fibrous tissue is incised at different places loosening the contractures)
- Fasciectomy (the diseased tissue is removed)
- Fasciectomy with skin grafting (the diseased tissue along with skin is removed and skin graft is applied on the defect)
Frequently Asked Questions
Is there any medical treatment?
Medicines have no role in the treatment of Dupuytren contracture. Only effective treatment is surgery.
Do supplements have any role?
As the disease is more aggressive and common in diabetics and alcoholics (these people are usually deficient in vitamins and minerals due to
their dietary limitations), so there may be a nutritional factor in the development of the disease, but it has yet to be scientifically proven.
When is surgery indicated?
Surgery is indicated when the contractures interfere with daily activities.
Can the deformity recur after surgery?
Yes, it can recur, and may require re-operation.
How long will it take to regain useful function of the hand after surgery?
After surgery you will require physiotherapy and it can take 4 to 6 weeks, to regain useful function of the hand.
I hope the information provided was helpful. If you have any query you can ask me at the contact me page.
This page was last updated on 6th February 2009.
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