Dupuytren's disease is a condition where the thick layer of tissue located between the skin and the tendons of the palm is thickened and/or contracted. Sometimes nodules and cords can be felt as masses on the palm and fingers. This thickened tissue or fascia can contract progressively and produce unwanted bending of the involved fingers, limiting the complete extension of the knuckles and the finger joints. As in the hand, the same structures in the foot can be involved.
WHAT CAUSES DUPUYTREN'S DISEASE?
The cause of Dupuytren's disease is unknown. It is a non-malignant condition and is usually painless. Hand injuries are not related as a cause of this condition. Dupuytren's disease is more common in males than females, and is seen more frequently in patients of Northern European descent. The condition usually runs in families.
WHAT ARE THE SYMPTOMS?
Dupuytren's disease progresses slowly. Usually diagnosed in men over 40 years of age, it may initially exhibit as a small "knot" on the palm of the hand. As it progresses, the formation of hard cords from the palm of the hand to the fingers may start producing bending of the fingers. The most commonly affected are the ring and small fingers. Usually, patients seek medical advice when permanent bending is present and normal use of the hand cannot be obtained. Often patients cannot place their hands into pant pockets or place their hands flat on even surfaces due to the limited extension of the fingers.
WHAT IS THE TREATMENT FOR DUPUYTREN'S DISEASE?
Mild cases may be treated with splinting to prevent contractures or permanent bending. Your hand surgeon may recommend a night splint maintaining fingers in the extension position along with stretching exercises.
The goal of surgery is to restore the normal function of the fingers to diminish the contracture. Surgery is necessary when the contractures prevent the normal use of the hand and the fingers involved. Generally, when patients are unable to lay their hands flat, surgery is recommended. Skin grafts are sometimes necessary during surgery to cover open areas after releasing the contracture. After surgery, splints may be recommended to help keep the fingers straight. In some cases, the condition may recur.