A Patient’s Guide to Dupuytren’s Contracture

The following information is from the American Society of Hand Therapists and is available as a handout from their website: http://www.asht.org.

Photo from orthoinfo.aaos.org showing Dupuytren’s contracture in a patient’s ring finger.

What is Dupuytren’s Contracture?

Dupuytren’s contracture, also known as Dupuytren’s disease, is a condition in the hand that causes the fascia, or layer of tissue beneath the skin, to tighten and draw the fingers in the palm. Dupuytren’s disease develops over time and is most common in the ring and small fingers; however, it may be found in any digit of the hand.

Illustration from physiocheck.co.uk.

What are the symptoms of Dupuytren’s Contracture?

Initially you may feel a lump or thickening of tissue in the palm; however, with time, Dupuytren’s disease can progress. Thick cords may develop in the palm and make it difficult to open the hand to hold change, or to place the hand in a pocket. The cords may also become sensitive and limit the ability to grip tools. The tightness of skin in the palm and the bent position of the fingers may take months or years to develop. Dupuytren’s disease can occur in both hands, although one hand is typically worse than the other.

What causes Dupuytren’s contracture?

The exact cause of Dupuytren’s disease is not known. Dupuytren’s disease is found most often in older males. Smoking, diabetes, and having a family member with Dupuytren’s disease are all risk factors.

What is the treatment for Dupuytren’s contracture?

Dupuytren’s disease is diagnosed by a physical exam. Your physician may monitor the nodules for change in size or thickness. For many, the nodules in the palm do not progress or become painful; however, when the fingers become stiff and limit the ability to use the hand, a referral to a hand surgeon is necessary. Surgery may be performed to remove the nodules and thick tissue in the palm. Your surgeon may also recommend a special injection and manipulation to straighten the fingers.

What can a hand therapist do for me?

A hand therapist works closely with the physician to help treat Dupuytren’s disease after surgery. Post-operative care involves fabrication of an orthosis to keep the fingers extended, a home exercise program to perform active range of motion and scar management and a strengthening program to regain functional use of the hand.