health topics

How Do You Get Dupuytren's Contracture?

The cause of Dupuytren's disease, a condition that causes thickened tissue in the hand that can cause the fingers to pull inward, is unknown. Risk factors include being male, age over 40 years, northern European ancestry, family history, heavy alcohol consumption, smoking, previous hand injury, medical conditions (diabetes, liver disease, etc.), and medications.
The cause of Dupuytren's disease, a condition that causes thickened tissue in the hand that can cause the fingers to pull inward, is unknown. Risk factors include being male, age over 40 years, northern European ancestry, family history, heavy alcohol consumption, smoking, previous hand injury, medical conditions (diabetes, liver disease, etc.), and medications.

The cause of Dupuytren's disease is not completely known, though it is believed genetics plays an important role.

Risk factors believed to contribute to the development or worsening of Dupuytren's disease include:

  • Being male 
  • Age over 40 years
  • Ethnicity: People of northern European (English, Irish, Scottish, French, and Dutch) and Scandinavian (Swedish, Norwegian, and Finnish) ancestry are more likely to develop the condition
  • Family history of the condition
  • Heavy alcohol consumption
  • Smoking
  • Previous injury to the hand
  • Certain medical conditions
  • Use of certain medications 
    • Anti-epilepsy drugs such as phenobarbital
    • Isoniazid
    • Tetracycline and fluoroquinolone antibiotics
    • Ropinirole
    • Metoprolol
    • Vemurafenib

What Is Dupuytren’s Contracture?

Dupuytren's contracture (also called Dupuytren's disease, Morbus Dupuytren, Viking disease, and Celtic hand) is a connective tissue disorder that can affect one or both hands. With Dupuytren's contracture, the fascia (connective tissue underneath the skin) of the palm of the hand thickens and tightens, slowly worsening over time, pulling the fingers inward. It most often affects the ring finger and little finger (pinky finger).

The condition can range from mild with little to no disability, to severe, in which patients have difficulty using their hand.

What Are Symptoms of Dupuytren’s Contracture?

An early symptom of Dupuytren's contracture includes thickening of the tissue under the skin on the palm of the hand (usually painless). It may affect one or both hands. 

As the condition progresses, other symptoms of Dupuytren's contracture may include:

  • Hard bumps (nodules) under the skin on the palm
  • Bands (cords) of thick tissue under the skin on the palm
  • Finger joint stiffness
  • Difficulty straightening one or more fingers all the way (usually the ring and little fingers)
  • Pits within the palm

How Is Dupuytren’s Contracture Diagnosed?

Dupuytren’s contracture is diagnosed with a patient history and physical examination. The diagnosis is usually based on the appearance of a patient’s hands and fingers and the range of movement. Imaging studies are generally not needed.

What Is the Treatment for Dupuytren’s Contracture?

Dupuytren's contracture is a slowly progressive condition and it does not go away on its own. Treatment is aimed at managing the condition and reducing symptoms. Treatment varies depending on the severity of the symptoms.

In mild cases, medical treatment may not be needed. Home remedies to manage symptoms include: 

  • Modifying tools by cushioning handles or using padded gloves to help with grasping 
  • Massage to help relieve pain
  • Hand exercises to keep fingers flexible and maintain hand function

Treatment for more serious cases of Dupuytren's contracture includes: 

  • Radiation 
    • High doses of X-rays are beamed at the hand to help slow the progression of the disease 
    • Only effective during the active phase of the condition when nodules are growing and cords are developing
  • Needle aponeurotomy 
    • A needle is stuck into the palm to break apart the thick tissue
  • Medications
    • Collagenase injection (Xiapex) is injected into the palm can help soften and break up thick tissue
  • Surgery to remove or break apart thick tissue.
References
https://www.uptodate.com/contents/dupuytrens-contracture-the-basics?search=Dupuytren%27s%20Contracture&source=search_result&selectedTitle=1~27&usage_type=default&display_rank=1

https://orthoinfo.aaos.org/en/diseases--conditions/dupuytrens-disease/

http://dupuytrens-society.org.uk/information/risk-factors/