Dupuytren's contracture: Causes, symptoms, diagnosis and treatment

If you have hand fingers flexed that you find them difficult to straighten, you may have a condition called dupuytren’s contracture. You may also notice a knot under the skin of your hand finger. This condition can be managed by either medication or surgery.

Causes

Doctors do not know exactly how dupuytren’s contracture develops. This condition is frequently found in those with smoking, alcohol abuse, family history of dupuytren’s contracture and repeated hand traumas. Men are more likely to develop this condition and tend to develop more severe contracture. People of Northern European descent are at higher risk of this disease. People with diabetes also have a higher risk of this disease.

There is a view although lack of evidence that repeated hand trauma from repeated hand uses for certain occupations is the cause of dupuytren’s contracture. The hand tendons that control the movement of your finger joints are injured and scar tissues form. The scar tissue would significantly limit your tendon’s motion and cause your tendons to be retracted.

Symptoms

The main symptoms of dupuytren’s contracture are the presence of hard band tissue in your finger and the inability of your finger to extend. Typically, the symptoms of dupuytren’s contracture develop gradually. In the initial phase, the disease may present as thickening of the skin of your palm. With progression over years, a lump of hard tissue can develop on your palm. In the later stages of dupuytren’s contracture, you may find that your fingers are contracted toward your palm, and it is increasingly difficult to extend your fingers. Your ring finger and little finger are the most commonly involved. The flexed fingers may cause trouble for daily work or living.

Diagnosis

In the majority of cases, the diagnosis of dupuytren’s contracture is straightforward. Your doctor needs to have a look at your hands and feel the knots or lumps under the skin to make a diagnosis. Your doctor may also ask you to extend your fingers in both of your hands to compare.

Treatment

You may need no treatment if this condition causes no problem. You may need no treatment at the early stage of this disease, since spontaneous regression (your hand’s self-repair) has been reported in some cases. However, in some other cases, the disease would not go away and you’ll have to get it treated.

There are medical and surgical treatments for this condition. For medical treatment, your doctor may recommend injecting collagenase clostridium histolyticum (Xiaflex), which is FDA-approved, to break down the scar so that you may restore the flexibility of your fingers. For those without access to this drug, doctors may recommend to use needle punctures to the lump area to break the fibrous scars that contract your fingers. The efficacy for this procedure is varied, but you can repeat it if the fibrous scar comes back. In those who do not respond to nonsurgical treatments or the condition is severe enough that nonsurgical treatments would not be expected to be working, your doctors may recommend surgery to resect the fibrous tissue. After surgery, you’ll need physical rehabilitation to regain the normal finger function.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.