About Dupuytren’s Contracture
Dupuytren’s contracture is a condition that can limit hand function over time. It’s actually part of the progression of Dupuytren’s disease, where tough scar-like tissue develops under the skin.
When the tissue under the skin thickens and forms a rope-like cord in the palm, it’s known as Dupuytren’s contracture. Over time, this cord can tighten and pull the finger toward the palm, preventing fingers from straightening.
Dupuytren’s contracture can progress quickly or develop over a period of years. The disease is not arthritis or even a normal part of getting older.
Progression to Dupuytren’s contracture
Before the contracture happens, patients may see changes in the palm, caused by Dupuytren's disease.
- Lumps, called nodulesNodule [NAH dyool]: a small knot or lumpX, may form at the base of the finger
- A dimple may appear on the surface of the palm. This is called pittingPitting dimple or indention on the surface of the palmX
- One or more fingers gradually curl downward toward the palm
This curling is known as the contracture. It can keep the fingers from straightening. As the contracture gets worse, the ability to move the fingers lessens.
Development of Dupuytren's contracture
One way to test if you have Dupuytren's contracture is to try to lay your hand flat on a table. If your fingers cannot lie flat, you might have Dupuytren's contracture. Talk to your doctor if you notice any of these changes to your hands. You may be referred to a hand specialist who can talk to you about treatment, including a nonsurgical option.
How the contracture happens
Patients with Dupuytren's may first see a lump, or nodule, at the base of the finger before the contracture happens. It occurs just beneath the skin in tissue known as the fasciaFascia [FAH shuh]: sheet of fibrous tissue that lies beneath the skinX. As the condition gets worse, a buildup of collagenCollagen [KOL uh jehn]: a protein that is normally part of many tissues in the body, like skin and fasciaX forms in the palm, leading to a rope-like cord.
This cord slowly thickens and "contracts,” pulling the finger downward and keeping it from straightening.
How many fingers are affected?
- Contracture can involve the joints at the base of your finger and the middle of your finger
- It may be seen in one or both hands
It can affect all fingers, but most commonly impacts the ring and pinky finger
- Contracture of the middle finger is less common
- The index finger and thumb are rarely affected
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