Dupuytren’s Disease – also called Dupuytren’s Contracture – is a condition that affects the tissues on the palm of the hand. Over time, knots can form in these tissues causing the fingers to be pulled into a bent position. The little finger and ring finger are most commonly affected and as the disease develops it can become impossible to straighten the fingers. This makes simple actions like shaking hands or holding large objects very difficult.
Causes of Dupuytren’s Disease
The precise causes of Dupuytren’s Disease are not known however certain factors appear to increase your risk of developing the condition. If you have a family history of the disease you are more likely to develop Dupuytren’s Disease and it is also more common in people who have diabetes or who smoke and/or drink alcohol. Men are at greater risk than women and it occurs most often in people over the age of 50. Being of Northern European descent also increases the likelihood of developing the condition.
Symptoms of Dupuytren’s Disease
Symptoms develop gradually, often over many years. The first signs of the disease appear as a thickening of the skin which may start to become dimpled or puckered. In time, a discernible knot develops under the skin of the palm. It is not normally painful but can sometimes feel sensitive to the touch. As the condition worsens, cord of hard tissue develop under the skin which tighten, pulling your fingers in towards your palm. Dupuytren’s Disease can develop in both hands although one is normally more seriously affected than the other. The condition is most often seen in the little finger and ring finger. Sometimes the middle finger may also be affected but it is rare for it to affect the index finger and thumb.
Diagnosis of Dupuytren’s Disease
A physical examination is normally sufficient to diagnose Dupuytren’s Disease. Your doctor may examine the skin of your palms for signs of puckering or knotty tissue. You may be asked whether you can lay your hand flat against a surface or straighten out your fingers as both are likely indicators of the condition.
Treatment of Dupuytren’s Disease
Dupuytren’s Disease normally develops slowly. While there is no cure for the condition, there are treatments that can slow the progress of the disease and provide some relief from symptoms. Needling – repeatedly inserting a needle through the skin – is used to break up the tough bands of tissue that are causing the fingers to contract. The contracture often recurs but the procedure can be repeated if necessary. However, some parts of the palm can’t be needled as there is a risk of damage to an adjoining nerve or tendon. Once the disease is more advanced you may require surgery to remove the tissue that is causing the fingers to contract. In the most severe cases, the surgeon may need to remove the skin as well as the tendons beneath it. This will require a skin graft and an extended recovery period.
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