Definition of Dupuytren contracture
Dupuytren contracture: A localized formation of
scar tissue in the palm of the hand. The scarring
accumulates in a tissue called the fascia beneath the skin of the
palm that normally covers the tendons that pull the fingers
grip. As Dupuytren contracture progresses, more of the
fascia becomes thickened and shortened. Dimpling and
puckering of the skin over the area eventually occur.
The precise cause of Dupuytren contracture is not
known. However, it is known that it occurs more frequently in males than females and in people of Northern European extraction. Risk factors include a history of hand trauma (such as from a jackhammer), diabetes mellitus, seizure disorders (epilepsy), smoking, alcoholism, and HIV infection. Dupuytren contracture also can be inherited in an autosomal dominant manner, affecting males and females in succeeding generations in a family.
Most patients with Dupuytren contracture only require
reassurance and stretching exercises with heat
application. When the palm is persistently sore with
grasping, ultrasound treatments can be helpful. Sometimes
local inflammation is best relieved with cortisone
injection.
For patients with significant fixed flexed posture
(contracture) of the fingers from Dupuytren contracture,
surgical procedures can remove the scarred tissue to free
the fingers. These procedures can return function to a
disabled hand. Minor nodule formation and/or skin
thickening of the palm is not a reason to operate. Sometimes the
surgeon can release the scarred tissue by carefully cutting it with a
needle. This procedure is referred to as a needle aponeurotomy.
Last Editorial Review: 9/9/2003
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