What is Dupuytren's Disease
Dupuytren’s contracture (also called Dupuytren’s disease) is an abnormal thickening of the skin in the palm of your hand at the base of your fingers. This thickened area may develop into a hard lump or thick band.
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Understanding Dupuytren's disease
Dupuytren’s Disease is a condition that affects the palmar fascia. This is a structure that lies between the skin and the tendons on the palmar side of the hand. The palmar fascia is like a mesh that stabilizes the skin from gliding excessively over the underlying tendons. Dupuytren’s Disease occurs when the palmar fascia spontaneously contracts, causing the fingers to bend. For some patients, this may only cause a lump on the palmar side of the hand. More advanced cases will have bent fingers that cannot be straightened out. This is not a painful condition. Dupuytren’s Disease is not usually a functional problem unless the digits become excessively bent, thus interfering with activities of daily living. Not all patients with Dupuytren’s Disease will require intervention or have any significant deformity in the fingers.
Dupuytren’s Disease is a genetic condition that is thought to originate from the Vikings. As such, most patients are of northern European heritage and in Canada, many patients can trace their heritage to English, Scottish, or Irish origins. The disease is usually transferred from men to their male offsprings. However, women can contract the disease if both parents are carriers. As such, the disease is much more common in men and the incidence increases with advancing age.
The early disease is usually evidenced by the appearance of a small nodule in the palm. Most commonly, it is in line with the ring finger. This nodule can be followed by possible pitting in the palm, as the diseased tissue pulls on the overlying skin, just distal to the nodule. If the condition does progress, it may extend into the fingers, causing them to bend at either the most proximal joint, named the metacarpal phalangeal (MCP) joint or, it may bend the finger at the next joint in the digit, named the proximal interphalangeal (PIP) joint. The ring and little fingers are the digits most commonly affected but it can affect any digit of the hand.
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