Dupuytren's Contracture: Causes, Symptoms, and Treatment
Dupuytren's contracture is an abnormal thickening and tightening of the normally elastic tissue beneath the skin of the palm and fingers. This tissue is called fascia. The fascia contains strands of fibers, like cords, that run from the palm upward into the fingers. In Dupuytren's contracture, these cords tighten, or contract, causing the fingers to curl forward. In severe cases, it can lead to crippling hand deformities.
What Causes Dupuytren's Contracture?
The cause of Dupuytren's contracture, also called Dupytren's disease, is unknown, but certain biochemical factors that affect the palm's connective tissue may be involved. Injuries and overuse of the hand do not play a role. Tendons are not affected.
However, certain things may make you more likely to develop Dupuytren's contracture. They include:
- Drinking a lot of alcohol, although most people with the disease do not have alcoholism
- Seizures, such as those seen in people with epilepsy
The condition usually runs in families, which means it is inherited. You are also more likely to develop this condition if you have a Northern European (English, Irish, Scottish, French, Dutch) or Scandinavian (Swedish, Norwegian, Finnish) background.
Dupuytren's contracture is more common in men than women, particularly those over age 40.Your chances of developing it increase as you get older.
Symptoms of Dupuytren's Contracture
The first symptom for many patients is one or more lumps (nodules) under the skin in the palm of the hand. The lump may feel tender and sore at first, but this discomfort eventually goes away.
The nodules cause tough bands of tissue to form under the skin in the palm. These inflexible bands cause the fingers to bend, or "curl," forward toward the wrist. As this curling gets worse, it becomes difficult, if not impossible, to straighten the fingers.
The pinkie and ring fingers are most often affected, appearing clenched. Both hands are usually involved, although one may have worse symptoms than the other.
People with Dupuytren's contracture often have a hard time picking up large objects, or placing their hands into their pockets, something you might do on an everyday basis to retrieve coins, cash, or your ID card. If you have this condition, you may also find it difficult to place your hand flat on the table, wear gloves, or shake hands, among other things.
Diagnosing Dupuytren's Contracture
Your health care provider will examine your hands, wrists, and fingers. Diagnosis of Dupuytren's contracture typically involves feeling the palm areas to check for nodules and recording how many nodules are found. Your doctor will likely ask you to try to place your hands flat on a table.
Tests may also be done to:
- See how well you can grasp items with your hands.
- See how well you can pinch items with your fingers.
- Measure the feeling in your thumbs and fingers.
- Determine your range of motion in your fingers, to see if you can straighten them all the way.
These exams and tests will be repeated over time to determine if the condition is getting worse.