Our Dupuytren contracture Main Article provides a comprehensive look at the who, what, when and how of Dupuytren contracture

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.

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