Dupuytren’s Contracture

Palmar fibromatosis, otherwise known as Dupuytren's contracture is a genetic condition that affects the hands. Over time the layer of tissue that lies under the skin of your palm knots and creates a thickened cord, pulling a single or multiple fingers into a bent position. The affected fingers will not be able to be straightened. Dupuytren's contracture can have different patterns in which it affects the hands but mainly affects the two fingers farthest from the thumb and can range from mild to very severe.

What are the causes of Dupuytren's contracture?

It is known to have a genetic component, occurs most commonly after the age of 50 and risk factors include those with diabetes and tobacco and alcohol users.

How is Dupuytren's contracture treated?

If there are no or minimal contractures, it can often just be observed. In general Dupuytrens is a progressive disease.

Otherwise, treatment is aimed at releasing contractures once they have formed, and this can be done through different surgical techniques. Surgeries include a fasciotomy or a subtotal palmar fasciectomy. The goal for a fasciotomy is to divide the thickened cord to decrease the contracture and increase movement in the hand. The goal for a subtotal palmar fasciectomy, on the other hand, is to remove as much abnormal tissue as possible so that the fingers can become mobile again.

The most appropriate technique will be decided in consultation with each patient. It is often necessary to combine the contracture release with a skin flap or graft. In each case, intensive physical therapy will be needed afterwards.