Dupuytren’s contracture of the hand
Published in Health & Fitness
One of the more unusual conditions affecting the hands and fingers is Dupuytren’s contracture (also called Dupuytren’s disease). Here, one or more fingers become curled, which can make it difficult to pick up or hold objects or perform everyday activities.
Legend says the condition originated with the Vikings of Northern Europe, although this is debated. It was later named after the 19th-century French surgeon Guillaume Dupuytren, who did the first successful operation on the condition. Fast-forward to the 21st century, and Dupuytren’s contracture now affects about one in 20 Americans.
What is Dupuytren’s contracture?
Fascia is a sheet of fibrous tissue beneath the skin of the fingers and the palm. Dupuytren’s contracture is a thickening and shortening of this tissue.
This thickened area begins as a hard lump called a nodule. Over years to decades, it may progress to a thick band called a cord that causes one or more fingers to curl toward the palm and become stuck in a bent position. This can make it difficult to grasp objects, button clothes, use a computer, or perform other daily tasks.
The condition does not always get progressively worse. It may be stable for years or even improve in some people.
Which fingers are most likely to be affected?
The ring and pinky fingers are most often affected. But the condition can strike all fingers and the thumb.
“In about half of cases, the condition can affect both hands,” says Dr. Phillip Blazar, an orthopedic surgeon and Division Chief of Hand and Upper Extremity at Harvard-affiliated Brigham and Women’s Hospital. Fortunately, it rarely causes pain.
What causes Dupuytren’s contracture?
Currently, the cause is unclear. Still, several factors can increase a person’s risk, such as:
How is Dupuytren’s contracture treated?
Although there is no cure, treatments and occupational or physical therapy can help address symptoms and improve finger mobility. “Many people who have mild cases of Dupuytren’s find it has little impact on their ability to use their hands,” says Blazar.
However, moderate or severe cases can interfere with hand function. It’s possible to restore normal finger motion with nonsurgical treatments, such as:
“Your hand surgeon will discuss both treatment options to determine which is best for your situation,” says Blazar. “There are also some variations in the anatomy of the disease which may make one treatment or the other less favorable for a particular person or finger.” Both of these treatments don’t remove the cords, and the condition can return and require additional treatment.
What about surgical treatment?
If nonsurgical treatment does not relieve symptoms or you have a severe condition, surgery may be recommended. Surgical approaches include:
You wear a splint on the repaired hand during recovery. People should expect some pain, stiffness, and swelling afterward. The length of recovery varies for each individual, and also with how many fingers were operated on and which ones.
“Most people largely recover by three months, but some may not feel fully recovered for quite a bit longer,” says Blazar. Hand therapists can also help with strength and flexibility exercises to speed recovery.
Most people’s fingers move better after surgery. However, as with nonsurgical treatments, the contracture can come back, so some people may need additional surgery later on.
(Matthew Solan is executive editor at Harvard Men’s Health Watch.)
©2024 Harvard University. For terms of use, please see https://www.health.harvard.edu/terms-of-use. Distributed by Tribune Content Agency, LLC.