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Dupuytren's contracture : Causes, Types, Symptoms, Diagnosis and Treatment

 What is Dupuytren's contracture?

Dupuytren's unwellness may be a condition that affects the fascia—the fibrous layer of tissue that lies beneath the skin within the palm and fingers. In patients with Dupuytren's, the connective tissue thickens, then tightens over time. This causes the fingers to be forced inward, towards the palm, leading to what's called a "Dupuytren's muscular contraction."

In some patients, a worsening of Dupuytren's muscular contraction will interfere with hand performance, creating it tough for them to perform their daily activities. Once this happens, there are nonsurgical and surgical operation choices on the market to assist slow the progression of the unwellness and improve motion within the affected fingers.

The connective tissue may be a layer of tissue that helps to anchor and stabilize the skin on the palm aspect of the hand. while not the connective tissue, the skin on your palm would be as loose and mobile because the skin on the rear of your hand. In patients with Dupuytren's unwellness, this area's connective tissue slowly begins to thicken, then tighten.

Often, Dupuytren's is 1st detected once lumps of tissue, or nodules, type beneath the skin within the palm. This could be followed by erosion on the surface of the palm because the pathologic tissue pulls on the superjacent skin.

As Dupuytren's progresses, bands of connective tissue within the palm are converted into thick cords that may tether one or additional fingers and therefore the thumb into a bent position. This can be known as a "Dupuytren's muscular contraction." Though the cords within the palm could seem like tendons, the tendons aren't concerned in Dupuytren's.

In several cases, a Dupuytren's muscular contraction progresses terribly slowly, over a number of years, and should stay gentle enough specified no treatment is required. In moderate or severe cases, however, the condition makes it tough to straighten the concerned digits. Once this happens, treatment could also be required to assist cut back the muscular contraction and improve motion within the affected fingers. Typically, as a muscular contraction worsens, the involvement of the connective tissue becomes additional severe and treatment is a smaller amount possible to end in a full correction.

What is Dupuytren's contracture

Explanation of medical terms and concepts Dupuytren's contracture

Dupuytren's (du-pwe-TRANZ) muscular contraction may be a hand deformity that typically develops over years. The condition affects a layer of tissue that lies underneath the skin of your palm. Knots of tissue kind underneath the skin — eventually making a thick wire that may pull one or a lot of fingers into a bent position.

The affected fingers cannot be straightened utterly, which may complicate everyday activities like inserting your hands in your pockets, golf shot on gloves or shaking hands.

Dupuytren's muscular contraction primarily affects the 2 fingers farthest from the thumb, and happens most frequently in older men of Northern European descent. A variety of treatments are out there to slow the progression of Dupuytren's muscular contraction and relieve symptoms.

of the hand Dupuytren's contracture of the hand or simply Dupuytren's contracture (or "Dupuytren's" "Poupart contracture") is a condition in which the tissue in the palm of the hand becomes progressively thickened and collagen accumulates around bands of connective tissue The fingers are then bent towards each other and cannot be completely straightened out Contractures also may form in other areas including the soles of the feet known as Ledderhose phenomenon It affects about 1% of Americans at some point in their lifetime.[1] This condition

Dupuytren’s contracture is a condition that causes cords of tissue to grow under the skin in the palm of your hand and fingers These cords form underneath collagen which makes up part of your skin This condition can cause your fingers to bend toward each other and eventually become stuck together.

Symptoms Dupuytren's contracture

A Dupuytren's contracture usually progresses terribly slowly, over an amount of years. Signs and symptoms of the condition might embody.

Nodules. you'll develop one or additional little lumps, or nodules, within the palm of your hand. These nodules are usually mounted to the superjacent skin. Initially, the nodules might feel tender however, over time, this tenderness sometimes goes away. In some cases, there is often "pitting" or deep indentation of the skin close to the nodules.

Cords. The nodules might thicken and contract, causative to the formation of dense and difficult cords of tissue beneath the skin. These cords will prohibit or tether the fingers and thumb from straightening or from spreading apart.

Contractures. because the tissue beneath the skin tightens, one or additional of your fingers is also forced toward your palm and should be restricted from spreading apart. The ring and small fingers are the unit most typically affected, however any or all of the fingers are often concerned, even the thumb. Most typically, the primary joint (knuckle joint) of the finger is affected, however the opposite joints can also be concerned.

As the bend in your finger will increase, it's going to be laborious to straighten it totally. it's going to be troublesome to know giant objects, place your hand in your pocket, or perform alternative straightforward activities.

Some patients with Dupuytren's illness might develop thickened tissue on the feet (Ledderhose disease) or erectile organ (Peyronie's disease). Symptoms don't occur anywhere else on the body.

Dupuytren's contracture usually progresses slowly, over years. The condition sometimes begins as a thickening of the skin on the palm of your hand. Because it progresses, the skin on your palm would possibly seem puckered-up or marked. A firm lump of tissue will type on your palm. This lump can be sensitive to the bit however sometimes is not painful.

In later stages of Dupuytren's contracture, cords of tissue type beneath the skin on your palm and might extend up to your fingers. As these cords tighten, your fingers can be forced toward your palm, generally severely.

The two fingers farthest from the thumb area unit most typically affected, tho' the center finger can also be concerned. solely seldom area unit the thumb and index affected. Dupuytren's contracture will occur in each hand, the' one hand' is typically affected additionally severely.

Causes Dupuytren's contracture

The reason for Dupuytren's unwellness isn't fully known, however most proof points towards biology as having the foremost necessary role.

There are associated anecdotal reports of Dupuytren's rising or worsening when a patient experiences an injury or an open wound (including surgery) to his or her hand; but, there's no smart proof to support this. There's additionally no compelling proof to counsel that it's caused by overuse of the hand.

Doctors do not know what causes Dupuytren's muscle contraction. There is no proof that hand injuries or occupations that involve vibrations to the hands cause the condition.

Risk factors Dupuytren's contracture

A number of things square measure believed to extend your risk of the unwellness, including:

  • Age. Dupuytren's contracture occurs most commonly after the age of 50.

  • Sex. Men are more likely to develop Dupuytren's and to have more severe contractures than are women.

  • Ancestry. People of Northern European descent are at higher risk of the disease.

  • Family history. Dupuytren's contracture often runs in families.

  • Tobacco and alcohol use. Smoking is related to associated increased risk of Dupuytren's contracture, maybe due to microscopic changes at intervals in blood vessels caused by smoking. Alcohol intake is also related to Dupuytren's. 

  • Diabetes. People with diabetes are reported to have an increased risk of Dupuytren's contracture.


Dupuytren's muscular contraction will build it tough to perform bound functions exploiting your hand. Since the thumb and finger are not typically affected, many of us haven't got abundant inconvenience or incapacity with fine motor activities like writing. However, as Dupuytren's muscular contraction progresses, it will limit your ability to totally open your hand, grasp massive objects or to induce your hand into slim places.

Diagnosis Dupuytren's contracture

In most cases, doctors will diagnose Dupuytren's muscle contraction by the design and feel of your hands. different tests square measure seldom necessary.

Your doctor can compare your hands to every different and check for puckering on the skin of your palms. He or she's going to additionally go on elements of your hands and fingers to examine for toughened knots or bands of tissue.

Your doctor additionally would possibly check to examine if you'll place your hand flat on a work surface or different flat surface. Not having the ability to totally flatten your fingers indicates you have got Dupuytren's muscle contraction.

Treatment Dupuytren's contracture

Although it varies from patient to patient, Dupuytren's sometimes progresses terribly slowly and should not become difficult for several years. In fact, for a few patients, the condition could ne'er progress on the far side developing lumps within the palm.

If the condition progresses, your doctor could 1st suggest medical procedure treatment to assist slow the sickness.

If the sickness progresses slowly, causes no pain and has very little impact on your ability to use your hands for everyday tasks, you would possibly not want treatment. Instead, you'll wait and see if Dupuytren's muscle contraction progresses. you'll want to follow the progression with a work surface check, that you'll do on your own.

Treatment involves removing or calling it quits the cords that area units pull your fingers toward your palm. this could be wiped out in many ways. The selection of the procedure depends on the severity of your symptoms and alternative health issues you'll have.


This technique uses a needle, inserted through your skin, to puncture and break the twine of tissue that is getting a finger. Contractures typically recur however the procedure may be continual.

The main blessings of the needling technique square measure that there's no incision, it may be done on many fingers at identical time, and frequently little physiatrics is required later on. The most disadvantage is that it cannot be employed in some places within the finger as a result of it may harm a nerve or sinew.

Enzyme injections

Injecting a sort of catalyst into the taut twine in your palm will soften and weaken it — permitting your doctor to later manipulate your hand in an endeavor to interrupt the twine and straighten your fingers. The office has approved enzyme eubacteria histolyticum (Xiaflex) for this purpose. the benefits and downsides of the catalyst injection area unit the same as needling. Catalyst injections aren't offered to the least bit of medical establishments.


Another option for individuals with advanced illness, restricted performance and progressing illness is to surgically take away the tissue in your palm suffering from the illness. The most advantage to surgery is that it leads to a lot of complete and longer-lasting unleash than that provided by the needle or accelerator ways. The most disadvantages are that physiatrics is sometimes required when surgery, and recovery will take longer.

In some severe cases, particularly if surgery has not corrected the matter, surgeons take away all the tissue seemingly to be suffering from Dupuytren's muscle contraction, together with the hooked up skin. In these cases a tegument is required to hide the open wound. This surgery is the most invasive choice and has the longest recovery time. individuals typically need months of intensive physiatrics later.

Lifestyle and home remedies

If you have mild Dupuytren's contracture, you can protect your hands by:

  • Avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape

  • Using gloves with heavy padding during heavy grasping tasks

However, your condition may persist or worsen, despite these precautions.

Preparing for your appointment

While you would possibly initially bring your symptoms to the eye of your general practitioner, he or she would possibly refer you to a medical science physician.

What you can do

Before your appointment, you might want to write a list that answers the following questions:

  • Do you have a family history of this problem?

  • What treatments have you tried? Did they help?

  • What medications and supplements do you take regularly?

What to expect from your doctor

Your doctor might ask some of the following questions:

  • When did your symptoms begin?

  • Have they been getting worse?

  • Is your hand painful?

  • How does the contracture interfere with your day-to-day tasks?

General summary

This is an extremely common question among those suffering from Dupuytren's contracture There are many treatment methods for this condition but the most important part is to make sure that you keep your hands warm at all times Your Dupuytren's contracture will get worse if your hands aren't kept warm at all times Keeping a pair of gloves with you at all times should be enough to prevent any trouble from coming your way if you start developing signs of the ailment That said there are some home remedies that may help alleviate the pain associated with this condition Dietary changes like eating sufficient and regular consumption

How do you fix Dupuytren's contracture without surgery?

Dupuytren's contracture is a condition in which the fascia or connective tissue that covers the palmar surface of the hand thicken and cords form underneath These cords cause affected areas to contract and reduce from finger flexion This condition most often develops in men over 40 years of age with no history of trauma nerve injury or connective tissue disease

What aggravates Dupuytren's contracture?

Dupuytren’s contracture is an ailment that occurs in the hands when a person has too much collagen or connective tissue in their palmar fascia This illness develops over time and tends to worsen with age It frequently develops among men between the ages of 40 and 60 years old Obesity can aggravate this disorder by adding excess pressure onto the affected hand It can also trigger the issue through direct trauma from heavy lifting or twisting motions that put strain on the hand

Can Dupuytren's contracture go away?

Yes Dupuytren's contracture can go away without treatment The severity of the disease may vary from person to person and it could be hard for someone to experience spontaneous recovery within a few months or years It is essential to always take note that since surgery becomes inevitable when it comes as a result of other underlying diseases such as diabetes the condition will most likely recur after healing has been done

What happens if Dupuytren's contracture is left untreated?

Left untreated Dupuytren's contracture can lead to permanent changes in finger movement The ring and small fingers will be pulled towards the palm of your hand The middle finger becomes extended and crooked often causing it to be misdiagnosed as a trigger finger If the condition worsens and the ring finger pulls downward into the palm the trigger-finger type symptoms appear and are diagnosed incorrectly as a flexion deformity with clawing of all four fingers

Can vitamin E help Dupuytren's?

In laboratory experiments vitamin E has been shown to slow the progression of Dupuytren's Contracture Vitamin E helps stop scar tissue from forming in the fibrotic bands and helps to release these fibrotic bands

Does magnesium help Dupuytren's contracture?

This question is based on the fact that magnesium can be associated with collagen synthesis which is an important component of connective tissues Therefore it may be worthwhile to consider taking Magnesium supplements as a way to treat Dupuytren's contracture Although some studies have not shown any benefit [14] one study showed that oral Magnesium Sulfate treatment improved the symptoms although surgery was still needed in the end[15] However there are no significant data to support this conclusion from these trials

Does massage help Dupuytren's?

While there is no definitive cure for Dupuytren's massage therapy can help manage the condition Massage may feel soothing and relaxing while helping to relieve pain associated with the disease Talk to your doctor about what type of massage modality is right for you particularly if you have concerns or problems with edema osteoporosis or diabetes Once you find a massage therapist that works well with you schedule sessions on a regular basis in order to maintain positive results

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