Dupuytren’s Contracture

This condition was first described in detail by Baron Dupuytren in 1832, when he pointed out two main causes for the disease. The first is genetic predisposition, which Dupuytren saw as the main cause for the contracture. Of course there are several other possible causes, such as major or minor injury. Irrespectively of the cause, when operating on the hand the surgeon always encounters a thickened palmar fascia, i.e. the binding layer between the skin and the tendons of the hand. The condition usually occurs at a higher age. Dupuytren’s disease often starts with nodules in the palm, usually on the little finger side. The nodules may be sensitive to pressure, but the function of the fingers remains unimpaired. The condition might progress slowly over several years, although rapid progression is also possible. The fingers most commonly affected are the ring finger and little finger, sometimes also the thumb and index finger. In patients with this condition the palmar fascia thickens and shortens, which can cause the fingers to curl. The patient can bend the affected finger, but cannot extend it, not even with the help of the other hand. Thus the hand becomes functionally impaired, preventing the patient from performing everyday activities.