Dupuytren’s contracture

Dupuytren’s contracture is a hand deformity that takes years to develop. The condition affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin that eventually create a thick cord that can pull one or more fingers into a bent position where the fingers can’t return to being straightened completely. Most commonly, the symptoms of Dupuytren’s contracture progress slowly over the years.

The symptoms can include:

• Thickening of the skin on the palm of your hand
• The skin on your palm might appear puckered or dimpled
• A firm lump can form on your palm
• Cords of tissue form under the skin on your palm, extending up the fingers pulling your finger toward the palm

While there are no know causes of Dupuytren’s contracture, there are a number of risk factors that are believed to increase your risk of the disease including:

• Age. Dupuytren’s contracture occurs most commonly after the age of 50.
• Sex. Men are more likely to develop Dupuytren’s and to have more severe contractures than are women.
• Ancestry. People of Northern European descent are at higher risk of the disease.
• Family history. Dupuytren’s contracture often runs in families.
• Tobacco and alcohol use. Smoking is associated with an increased risk of Dupuytren’s contracture, perhaps because of microscopic changes within blood vessels caused by smoking. Alcohol intake also is associated with Dupuytren’s.
• Diabetes. People with diabetes are reported to have an increased risk of Dupuytren’s contracture.

Treatment of Dupuytren’s Contracture

Treatment of Dupuytren’s Contracture can be achieved in multiple ways. The goal of treatment involves removing or breaking the cords that are pulling the fingers toward the palm. This can be achieved through an enzyme injection or surgery. Determining which treatment is appropriate for you is determined by the surgeon after assessing the severity of the contracture.

• The goal of injecting an enzyme into the cord is to soften and weaken it allowing for the surgeon to later manipulate and break the cord resulting in the ability to straighten your fingers. More information about the enzyme injection Xiaflex can be found at http://www.xiaflex.com.
• Surgery is another option for people with advanced Dupuytren’s disease. Surgery is used to remove the tissue in your palm affected by the disease through a small incision in the palm.