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Q: I would like to know what exactly Dupuytren's disease is and what treatments are there available?
A: Dupuytren's contracture consists in thickening and proliferative changes of connective tissue within the palm of the hands, with subsequent contracture formation. By definition, a contracture consists in tightening of body structures associated with a given body part, which thus leads to restriction of normal motion of the associated body part. In Dupuytren's contracture, nodules are first formed within the affected hand tissues, which then leads to a cord-like band formation and subsequent difficulties in extension of the affected fingers and, in severe cases, no lomger permitting extension of these fingers. This disease may occur in one or both hands, most commonly affecting the ring and the middle fingers. The cause of this disease is unknown. However, it occurs most frequently in men over 50 years of age, in persons having a family history of the disease, in persons having diabetes mellitus, alcoholism, liver cirrhosis, epilepsy, or tuberculosis, and in persons who have had a repetitive history of trauma. The disease is usually painless and may suddenly occur although, however, it usually slowly develops. Persons affected with the disease frequently complain of thickened bands, not being able to open fully their hands, of difficulties with grasping large objects, and not being able to shake hands. On physical examination, the affected fingers are essentially fixed, i.e., very difficult to move, palpable nodules are present, and thickened longitudinal bands which are connected with the fingers are visualized.
Treatment consists in surgical intervention if the contracture significantly prevents motion of the affected fingers. However, the contracture may reoccur following surgical treatment. If the nodules are growing rapidly, steroid injection within the nodules may be of help.
Updated: 07/09/99
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