Dupuytren’s Contracture

What is it?

A benign condition where there is thickening, fibrosis and contracture of the palmar and digital fascia. The ‘contracture’ pulls the finger down and be unable to be straightened. People can find this that this causes the finger to catch and cause difficulty with putting on gloves, taking things out of your pocket or washing your face.

What is it?

A benign condition where there is thickening, fibrosis and contracture of the palmar and digital fascia. The ‘contracture’ pulls the finger down and be unable to be straightened. People can find this that this causes the finger to catch and cause difficulty with putting on gloves, taking things out of your pocket or washing your face.

What causes it?

Dupuytren’s contracture is an inherited condition with incomplete inheritance (this means you might have the genes for Dupuytren’s contracture but not actually have the condition). It is common in populations of Northern European descent, rarer in Southern Europe and vanishingly rare in Africa or China. This has led to it being termed the ‘Viking gene’.

What happens if you do nothing?

If you have a contracture of the finger it will not get better by itself and will generally get worse with time. If the finger becomes very bent for a long time this can cause shortening of the other structures in the finger e.g. the collateral ligaments which can make it difficult to  get the finger completely straight following procedures.

What happens if you do nothing?

If you have a contracture of the finger it will not get better by itself and will generally get worse with time. If the finger becomes very bent for a long time this can cause shortening of the other structures in the finger e.g. the collateral ligaments which can make it difficult to  get the finger completely straight following procedures.

What treatments are there?

If the contracture is small e.g. you can put you hand flat on a table, observation is acceptable. If the contracture is worse than this it is generally worth considering having an intervention to try and straighten the finger. This may be something small like releasing the contracture with a needle (needle fasciotomy), injecting a collagenase enzyme to dissolve the cord (Xiapex – is currently not licensed for use in Europe). If the contracture is more severe surgery may be required – where the Dupuytren’s tissue is removed – if the deformity is severe sometimes a skin graft is required. It is important to understand that there is no cure for Dupuytren’s contracture but simply procedures to straighten the finger – as such it can recur in the treated finger.