The palm of your hand contains a tough layer of tissue called the palmar fascia. Dupuytren's contracture is a progressive condition in which there’s an abnormal thickening of this tissue at the base of your fingers. Over time this thickening under the skin can form a rope-like cord.
Over time – usually years – this thickening can cause one or more fingers to curl (contract) toward your palm, or pull sideways. The ring and little fingers are most commonly affected. In many cases, it affects both hands. Rarely, feet may also be affected.
Dupuytren's contracture is believed to be hereditary (it runs in families), and is more common in people of Scandinavian or Northern European descent (which is why it’s sometimes referred to as the Vikings’ disease).
The exact cause of the collagen buildup in Dupuytren’s contracture is not known, but it may be linked to cigarette smoking, alcoholism, diabetes, nutritional deficiencies, or taking medicines used to treat epilepsy.
While there’s no cure for Dupuytren’s contracture, there are effective treatments—both non-surgical and surgical—that can slow the disease or help ease your symptoms.
If left untreated, Dupuytren’s contracture may prevent you from straightening your fingers fully, interfering with your ability to use your hands for certain tasks. That’s why it’s important to see a specialist for an accurate diagnosis and appropriate treatment.
It’s also important to see a specialist because the symptoms of Dupuytren’s contracture can be similar to other conditions such as trigger finger or tendinitis.
Why Choose Cooper to Diagnose and Treat Dupuytren’s Contracture
Cooper University Health Care has a team of four fellowship-trained and board-certified or -eligible hand surgeons with extensive experience in diagnosing and treating Dupuytren’s contracture. You can count on us for:
- Timely, accurate diagnosis: In most cases, a specialist can diagnose Dupuytren’s contracture from the look and feel of your hands. A Cooper hand specialist will also test your grip and pinch strength, measure the degree of contracture, and the flexibility and feeling in your thumb and fingers. They'll also evaluate your ability to lay your hand flat (the tabletop test).
- State-of-the-art treatment: Treatment is tailored to the severity of your condition:
- Non-surgical injection of an enzyme called collagenase is the standard of care for most cases today. After a local anesthetic to numb the hand, the enzyme is injected into the thickened tissue where it breaks down and dissolves the bands. This allows the fingers to straighten when the surgeon snaps the cord, usually the day after enzyme administration.
- Surgery may be indicated in advanced cases when patients have limited use of their hands. The surgeon makes an incision and removes the thickened tissue, improving finger mobility.
Dupuytren’s Contracture Causes and Risk Factors
Dupuytren’s contracture is caused by a buildup of collagen under the skin that forms a rope-like cord at the base of the fingers. The specific reason for this isn’t known, but there are certain factors that appear to increase your risk for this condition:
- Age: The condition usually starts in middle age, after age 40
- Gender: It is more common in men than women
- Scandinavian or Northern European background: It is most common in people whose families come from these regions
- Family history: The condition often runs in families, so it may be inherited
- Taking seizure medicine: It is linked with some medicines used to treat epileptic seizures
- Smoking and alcohol abuse: The condition is more common in people who smoke or abuse alcohol
- Diabetes: Having diabetes also appears to increase the risk of getting Dupuytren’s
Symptoms of Dupuytren’s Contracture
The most common symptoms of Dupuytren’s contracture include:
- Small lumps (nodules) in the palm, at the base of the fingers; over time, the tenderness often goes away
- Some patients have burning, itching or temporary tenderness at the site of the nodules
- The skin on your palm may appear dimpled or puckered
- The nodules may thicken, forming rope-like cords of tissue under the skin
- The affected finger(s) may begin to curl (contract) toward your palm and stay in that position
- You are unable to lay your hand flat on a table, palm down
- Pits or grooves form in the skin compressed by the contracted finger
- You are unable to perform everyday activities like shaking hands or shampooing your scalp
Preventing Dupuytren’s Contracture
It is probably more realistic to think in terms of slowing the progression or recurrence of Dupuytren’s than preventing it, since this condition has a strong genetic (inherited) component. If you have early signs of Dupuytren’s contracture, consider these strategies:
- Avoid activities that increase the risk of hand trauma, which can speed progression
- Don’t smoke
- Limit or avoid alcohol
- Tightly control blood sugar levels if you have diabetes
- If you have had surgical or non-surgical treatment for Dupuytren’s contracture, wear the hand splints and do the exercises as your doctor prescribes
To learn more about the services available for treating Dupuytren’s contracture at Cooper or to request an appointment, please call 800.8.COOPER (800.826.6737).
Refer a Patient
If you are a doctor who wants to refer a patient to Cooper for Dupuytren’s contracture care, please call 800.826.6737.