Dupuytren’s contracture
Dupuytren’s contracture is a type of hand deformity that causes the tissue under the palms to contract. Over time, this connective tissue becomes very tough, causing knots of tissue to form. Eventually, these knots merge into a thick cord that can actually pull back one or more of a person’s fingers so that they become permanently bent. While the fingers can still be moved and bent as normal, they can’t be completely straightened out, leaving a person’s hand in a claw like position. This can make it very difficult to manipulate objects, especially as the condition worsens. Fortunately, Dupuytren’s contracture is fairly uncommon. It’s also very rarely painful, although the knots under the skin of the palms may be somewhat sensitive to the touch. Dupuytren’s Contracture doesn’t have to affect both hands, although it often does.
Dupuytren’s contracture first symptom is a slight thickening of the skin on the palm. Over time, this section of skin may start to look dimpled. Next, a lump of tissue will form under the skin. Then the cords of tissue will form and, over time, start to tighten up, pulling your fingers towards your palm. Again, there’s no real pain associated with this, even if your fingers become severely bent. Generally, the ring finger and little finger are most affected, although the middle finger may also be affected. The thumb and index finger are usually only bent in the most severe cases. You may notice one hand is more severely affected than the other; this is fairly common.
The progression of Dupuytren’s contracture is usually fairly slow. It usually takes several years to fully develop, although in some people, it may develop within several months or even weeks. For some, it progresses fairly steadily, while in others, it may start and stop several times. Some people suffer more from what doctors like to call Dupuytren’s disease instead of Contracture because their fingers do not become bent—the skin under the palm hardens but doesn’t tighten that much. This is often true of people who develop Dupuytren’s contracture as a side effect of diabetes.
In addition to diabetes, there are a few other risk factors that can increase a person’s risk of developing Dupuytren’s contracture. This includes family history, tobacco use, and alcohol use. It is possible that Dupuytren’s contracture is passed down through families, but there is no conclusive proof as of yet. Likewise, because of how they affect blood vessels, smoking and drinking alcohol do increase your risk of developing this disease.
Treatment for Dupuytren’s contracture differs depending on how the disease is progressing. If it is developing very slowly and doesn’t cause you pain or prevent you from using your hands for everyday, general tasks, then you might not need any type of treatment. Instead, your doctor may want to wait and see how the disease progresses. You will need to have regular checkups to see how it’s developing. This is generally done using a tabletop test. This test is very simple and can be done at home. Simply put your hands palm-down on a table. If you can flatten out your hand, then the disease has not progressed to the tightening phase.
If your doctor does decide you need treatment, it can come in several different ways. Steroid injections can help soften or flatten out the bumps under the skin, but you will need to get injections on a regular basis. Radiation therapy may also help to slow the progression of Dupuytren’s Contracture. Finally, needle aponeurotomy can be used to break the thick cords of tissue and allow your fingers to be straightened out again. In more severe issues, surgery can be done to remove the knots or even most of the tissue under your palm.
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