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Dupuytren's Contracture

Also known as Dupuytren's Disease, this condition causes one or more fingers to gradually bend towards the palm of the hand. It can affect either or both hands, and although it is often mild or painless, it can worsen over time and lead to a loss of practical function.

What is Dupuytren's contracture?

Under the skin of the palm is a layer of connective tissue (fascia). In Dupuytren's Contracture, this layer begins to thicken or shrink, developing small growths called nodules. This makes it difficult to straighten the fingers fully. Over time the condition can pull the fingers into a permanently bent or 'beckoning' position.

Dupuytren's contracture usually affects the little and ring fingers more than the middle and index fingers. It may also affect the appearance of the palm, causing visible lumps or dimples. It does not usually cause pain, although the nodules may be tender at first. However, as the condition develops over time, it can make it difficult to use the hands and fingers as normal.

What causes Dupuytren's contracture?

The first thing to know is that Dupuytren's disease affects many more men than women - by a factor of around seven to one. It is also more likely to affect men over 40 years of age.Although doctors do not know precisely why the disease develops in most individuals, there are a number of risk factors connected with Dupuytren's contracture. The first is heredity; it is supposed that the majority of cases are inherited to some degree. However, excess alcohol intake is also a risk factor, as are diabetes and epilepsy.

How do you treat Dupuytren's Contracture?

Treatments for Dupuytren's Contracture are dependent on the severity of the condition. If you get it looked at early, before the fingers become too bent, it may be possible to treat Dupuytren's with a night splint. This is a specially prescribed splint that helps the fingers to straighten when the hand is not in use.

More advanced cases can be treated with day surgery. The tight bands and nodules are carefully removed and if necessary, skin is grafted over the palm. This usually takes place under general anaesthetic. Post-surgery, you would keep the hand elevated for several days and have stitches removed within two weeks. A night splint is recommended for several months following surgery.

Recently, there has been a new development in the treatment of Dupuytren's disease in the UK.Xiapex injection, an enzyme-based treatment, is described on a separate page.