Dupuytren's Contracture

If there is a painless thickening of tissue beneath the skin on the palm of the hand and fingers, it is termed as Dupuytren’s contracture. If it increases and worsens it may result in the deformity of the hand and loss of its function. Contractures are tightening of muscles, or ligaments or skin resulting in painful movements or lack of normal movements of any part of the body.

Though the actual causes are uncertain and not known, a minor trauma and genetic predisposition may play a vital role in forming it. It may affect one hand or both hands, palms and fingers. And when fingers are affected, generally it is the ring finger, which is affected first and most often, followed by the little, middle and index fingers. A small, painless nodule develops in the connective tissue in the palm or fingers, which may develop into a cordlike band. It then becomes difficult to extend the fingers, which may become stiff or crooked in more serious and advanced cases.

Dupuytrens contracture generally affects more men than women and becomes common after the age of forty. Studies show that the risk factors are alcoholism, epilepsy, diabetes, liver disease or pulmonary tuberculosis. The painless nodule and the cord like band in the palms may progress to thickening of the lines in the palms of the hands and then extending the fingers become difficult with the fourth and the fifth finger curling up and refusing to straighten up. Movement becomes difficult and restricted.

The doctor will diagnose it with a physical examination and study of the medical history. Palpation may confirm the presence of a scar tissue which has thickened (fibrosis) and contracture. Warm water baths, exercises or splints may be advised to relieve the situation. The progression of the contracture is carefully monitored. If all this does not have any effect, surgery may be performed to release the contracture. The surgical procedure generally depends on the severity of the condition. Surgery can restore the normal movements of the fingers, which can be followed by physical therapy exercises prescribed by the doctor. The family and friends of the patient can help by advising him and seeing to it that he does the exercise prescribed by the doctor.

This type of contracture may be unpredictable. Though surgical treatment restores normalcy and proper movements of the fingers, it can recur in some cases. If untreated, it can cause deformity of the hand, loss of functions of the hand and risk of injury to blood vessels. Awareness and general knowledge can allow early detection and treatment.