What is Dupuytren’s contracture?
Dupuytren's contracture is a genetic hand disorder that causes one or more fingers to bend toward the palm of your hand. Having this condition makes it difficult to use your hand normally. There is no cure for this disease, but symptoms progress slowly over months or years.
The disorder makes tissue under the skin of your palm and fingers thicken and tighten. Your ring and little fingers are most often affected. As the condition worsens, you may find it difficult to do everyday activities like shaking hands or putting on gloves.
Nonsurgical and surgical hand treatments can help ease your symptoms.
What causes Dupuytren’s contracture?
There is no known cause of this hand disorder, but Dupuytren’s contracture often runs in families. Certain risk factors increase your chance of having this condition, including:
- Gender: Men are more likely than women to have this condition.
- Age: The condition usually occurs after the age of 50.
- Ancestry: People of Northern European descent are more likely to have the condition than others.
- Family history: This is considered a genetic condition often passed down from other family members.
- Having diabetes.
- Smoking and alcohol use.
Dupuytren’s contracture symptoms
The signs of Dupuytren’s can progress slowly over years. Symptoms are most commonly seen in the ring and little fingers.
- Earliest symptoms: The first symptom you may notice is a firm lump or several bumps under the skin of the palm of your hand. This lump may or may not be painful.
- Mild symptoms: The lump may eventually grow into a hard cord that tightens and pulls the tendons of your finger toward the palm. You may be unable to lay your hand flat on a table.
- Advanced symptoms: The most advanced symptom occurs when the cords under your skin become so tight that it might be impossible for you to extend or straighten your fingers.
Some people may not experience the full progression of the condition, and may not develop all symptoms.
How is Dupuytren’s contracture diagnosed?
You should see a doctor if you have any symptoms you suspect may be those of Dupuytren’s. Your doctor will examine your hand and test your flexibility. Your doctor may also test your grip and pinch strength.
If you have any visible nodules, your doctor may measure the range of motion in your fingers and how much they curl or extend. These tests may be repeated at a future date to determine how much the disorder may be progressing.
Our experts at the Hand and Upper Extremity Center at The Ohio State University Wexner Medical Center in Columbus, Ohio, will make a diagnosis based on a physical exam and your medical and family history.
Dupuytren’s contracture treatment
There is unfortunately no cure, but treatments are available to help ease symptoms and improve the daily use of your hand. Treatment options can include:
Physical therapy
Hand therapy with the experts at the Ohio State Wexner Medical Center can help slow the progression of the condition or ease your symptoms. Your physical therapists will show you certain stretches and exercises to improve your range of motion and increase flexibility.
Injections
- Steroid injections: In the early stages of the disorder, your doctor may inject a steroid into the nodules to soften or flatten them. The steroid injection may also ease pain you may be experiencing.
- Enzyme injection: Your doctor may recommend injecting an enzyme called collagenase into the nodules or cords to loosen and break down the growths in your hand. This may be combined with finger stretches to improve your range of motion.
Needling
During this treatment, your doctor will insert a small needle into the skin to puncture and break apart the cord of tissue that’s affecting your fingers. While you may need to have the procedure repeated over time, this same-day procedure can be done at one of our outpatient facilities throughout central Ohio.
Radiation therapy
Radiation therapy uses radiation aimed at the nodules or cords to loosen or break down the growths in your hand.
Surgery
Surgery is an option and is elective – the success rate varies depending on the severity of the condition. Your doctor may recommend surgery to remove tissue that’s bending the fingers. After surgery, you can return to work and/or driving when you feel confident and are no longer taking pain medications. Recovery time is different for everyone and can range between six weeks to four months.
What happens if you don’t treat Dupuytren’s contracture?
If the condition continues to progress and affects one or more of your fingers, symptoms may become more pronounced.
