Dupuytren’s Contracture
Dupuytren’s contracture is a hand deformity characterized by the development of thick cordages in the palm, through the tendons responsible for flexing the digits downwards.
Dupuytren’s has a strong genetic component. Onset is slow and progressive and it presents most commonly in older males of Northern European descent. However, it does also occur in other populations.
Thick cordages will become visible through the hand. Generally, onset begins at the small finger and ring finger. The cordages thicken and pull down the fingers into a claw hand, gradually involving all the other fingers. The cordage is usually not painful, but feels like a firm lump under the skin. Often, dimpling or wrinkling of the skin is visible as the disease progresses.
Cordage may be released by open surgery, needling, or injection of an enzyme. Following surgery, treatment focuses on scar management, stretching and therapeutic exercise/activity modification as necessary to restore strength and conditioning. Mild Dupuytren’s contractures may be treated with stretching and splinting to slow down progression of the disease.