Dupuytren Contracture

Overview


Plain-Language Overview

Dupuytren Contracture is a condition that affects the hand, specifically the connective tissue beneath the skin of the palm. It causes the tissue to thicken and form tight cords, which can pull the fingers inward, making it difficult to straighten them. This mainly affects the ring and little fingers, limiting hand movement and function. The condition develops slowly and is more common in older adults, especially men. It can interfere with everyday activities like gripping objects or shaking hands. The exact cause is unknown, but it involves changes in the fibrous tissue of the palm. Overall, it impacts the musculoskeletal system and hand dexterity.

Clinical Definition

Dupuytren Contracture is a progressive fibroproliferative disorder characterized by abnormal thickening and contracture of the palmar fascia. The core pathology involves myofibroblast proliferation and excessive deposition of type III collagen, leading to the formation of nodules and cords that cause flexion contractures of the metacarpophalangeal and proximal interphalangeal joints. It is thought to have a genetic predisposition with autosomal dominant inheritance and variable penetrance, often associated with risk factors such as alcohol use, diabetes mellitus, and smoking. The condition primarily affects the palmar aponeurosis and results in functional impairment of the hand. Clinically, it presents with palpable palmar nodules and progressive finger contractures, most commonly involving the fourth and fifth digits. The major clinical significance lies in the loss of hand function and decreased quality of life due to impaired finger extension.

Clinical Presentation


Diagnostic Workup


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Differential Diagnoses


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