What is Dupuytren's Contracture?
Dupuytren’s contracture is a condition in which the fingers bend inward toward the palm. Dupuytren’s contracture is usually painless, but may be disabling in severe cases when it prevents the fingers from straightening. It begins lumps or nudule is the palm. Overtime these join together to form a cord of tough tissue which contracts and causes curling of one finger into the palm. This progresses over time and may limit the movement of other fingers also.
What causes Dupuytren's Contracture?
Dupuytren’s contracture occurs when cells called fibroblasts collect within Dupuytren’s cord (a thick cord of tissue that runs along the palm, between the skin and tendons). These cells become trapped in a web of tough material called collagen. They also begin to contract, drawing the collagen fibers together into a single cord.
Dupuytren’s Contracture runs in families and is especially prevalent in people of Northern European descent. The underlying cause for Dupuytren’s disease is unknown, although it has been associated with certain lifestyle factors such as alcoholism, smoking, diabetes mellitus, and obesity. Symptoms are worsened by liver disease, chronic lung disease, and anemia.
How is Dupuytren's contracture treated?
Since it is genetic, it can’t be completely cured. There are some non-surgical methods of treating Dupuytren’s contractures though. Occupational therapy exercises aimed at slowly straightening the fingers can help. Splinting can help stretch the fingers throughout the day.
When Dupuytren’s contracture results in pain and decreased range of hand motion, more invasive treatment may be recommended. Mild to moderate cases may be treated with injections of collagenase, like Xiaflex. More severe contractures may require surgery to remove the contracted cords and nodules in the palm.
