What Is Dupuytren’s Contracture?
Although the cause of the condition remains unknown, the characteristics of Dupuytren’s contracture are easy to spot. Learn more about this type of hand deformity.Dupuytren’s (pronounced DOO-pa-trens) contracture is a type of hand deformity named after the French surgeon Baron Guillaume Dupuytren, who first described it in 1834. It affects tissue under the skin of your palm that’s connected to the tissue in your fingers. Dupuytren’s is most common in people of northern European descent and has even been called the Viking disease.
What Is Dupuytren’s Contracture?
Dupuytren’s contracture causes an overgrowth of the tissue under the skin of the palm. “This tissue, called the palmar fascia, gives the palm its thickness and padding,” explains Daryl O’Connor, MD, an orthopedic surgeon at Gottlieb Memorial Hospital, part of the Loyola University Health System in western Chicago. “As the tissue thickens, it also shrinks, causing the fingers to curl into a bent position, which is full Dupuytren’s contracture.”
What causes the thickening and tightening of Dupuytren’s is unknown. Doctors do know that it’s not the result of an injury or overuse of the hand. “The disease is more common in men, usually occurs after age 50, and can be hereditary, especially in families from Scandinavia and northern Europe,” Dr. O’Connor says. Other risk factors that may contribute to the disease include smoking, alcohol, and diabetes.
A 2009 review of Dupuytren’s published in the journal Hand looked at 49 studies, most done in Scandinavia and the United Kingdom, to see how common the condition is. Rates ranged from less than 1 percent to 56 percent, depending on age and other factors of the population studied. According to the review, 30 percent of Norwegians over age 60 and 4 percent of the male population of England are affected. It also found that men are affected about six times more often than women.
How Dupuytren’s Develops
Dupuytren’s contracture develops slowly, often over years. It may begin as one or two tender, small lumps in the palm. Over time these lumps thicken into cords which contract, causing the fingers to curl inward into the palm. The last two fingers (the ring and pinky fingers) are most commonly affected. The middle finger may also be involved, but the index finger and thumb are rarely affected.
Dupuytren’s contraction is usually painless, but you’re unable to straighten the affected fingers, which causes problems with grasping, buttoning, and getting your hands into gloves or pockets. Both hands can be affected, although one hand is usually more severe than the other.
Diagnosis and Treatment of Dupuytren’s Contracture
Dupuytren’s contracture usually progresses slowly and isn’t dangerous. “A diagnosis of Dupuytren’s contracture is made by a doctor examining the hand and seeing how the condition progresses over time,” O’Connor explains. Treatment can range from watchful waiting to injections to surgery. If the disease progresses slowly and causes no pain or problems with the ability to use your hands, treatment may not be needed.
How Dupuytren’s contracture may or may not progress is unpredictable. Some people only develop a firm lump of tissue under the skin of the palm, while others progress to develop a complete contracture of a finger or fingers. People who develop Dupuytren’s contracture at an early age are more likely to experience severe hand problems.
Unfortunately, there’s currently nothing that can be done to stop or cure the condition. Common self-care tactics such as forceful stretching or splinting won’t help and may even make the condition worse, which is why it’s better to have your doctor monitor and treat Dupuytren’s.
Tissue thickening and contraction similar to Dupuytren’s contracture may also be found in the penis (Peyronie’s disease), knuckles (Garrod’s pads), and feet (Lederhose’s disease). People with these conditions are more susceptible to having Dupuytren’s contracture, too.
“Non-surgical treatment options exist and may be successful in preventing or delaying Dupuytren’s contracture from progressing if the condition is found early,” O’Connor says. Injections that dissolve or disintegrate the thickened hand tissue can be done as an office procedure.
Let your doctor know if you start to have any of the signs of Dupuytren’s. Your doctor can assess how advanced the condition is and if treatment is needed.
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