Dupuytren's Disease - What is it?

Dupuytren's contracture 
is a condition of the hand 
in which the palm's 
connective tissue  
(fascia) proliferates, 
thickens and contracts.  
Palmar nodules are 
typically the first 
presentation of 
Dupuytren's.  As the 
palmar fascia thickens 
and the disease 
progresses, cords 
develop and contraction 
increases, flexing the 
fingers towards the palm.  
Overlying skin often 
dimples.  The ring and 
little finger are most 
commonly affected.  
Progression is often 
erratic and arbitrary with 
no obvious cause.

Associated conditions 

disease - fibrosis in 
the soles of the feet.

Peyronie's disease - 
fibrous plaques on 
the penis.

Knuckle pads - 
fibrous pads on the 
top of knuckles.

Baron Guillaume Dupuytren first described the disease in 1831. 

Who gets it?

Dupuytren's disease is a genetic disease.  It usually presents later in life with some incidences reported in children.  It is most prevalent in men of Northern European descent.  Diabetes, epilepsy, thyroid problems, alcoholism, liver disease and smoking are all considered predisposing factors.  Trauma and exposure to chronic hand vibration may also 
exacerbate this condition.

What are the treatment options?

Any CONTRACTION OF THE FINGERS is an indication for treatment with either Needle Aponeurotomy (NA) or surgery.  Any flexion of the finger joints - metacarpophalangeal (MCP), proximal interphalangeal 
(PIP) and/or distal interphalangeal (DIP) - that interferes with use of the hand should be released.  The sooner this is completed, the better the functional outcome.

There is no cure for this disease. Dupuytren's disease may reoccur after both NA and surgery (about 50% of patients experience recurrence of the disease within 2 or 3 years).  Treating recurrent disease after NA is easier than after open surgery.

Treatment options:

Needle Aponeurotomy (NA):  This is an outpatient 
non-surgical procedure in which a small hypodermic 
needle is used to release the contracting bands of 
Dupuytren's disease.  Immediate correction is  
noted.  Recovery is minimal.  Complications are  
few.  The expense is considerably less than surgery.

Open surgery:

-Fasciectomy:  This procedure completely 
 excises the diseased fascia of the palm and 
 digits. Requires general anesthesia or nerve 
 block. Extensive rehabilitation and recovery are 
 needed, often weeks or months.

-Fasciotomy: Hand incisions are made above 
 the hardened Dupuytren's cord.  Sharp 
 dissection is performed to facilitate release.  

Joints of the fingers


3000 N. HALSTED, STE 724