Dupuytren's Contracture

What are the signs and symptoms?

Patients may not remember when problems started or know they have a problem until they experience difficulty with activities and chores that rely heavily on use of their hands (putting on clothes, washing dishes, writing, wearing gloves, etc.)  Classically, patients find difficulty placing their hand flat against a surface such as a wall or table.

Early in the disease, firm and adherent small lumps or nodules appear on the palmar (volar) surface on the palmar fascia of the fingers or hand.  Early identification of these nodules is often difficult because they are often confused for calluses, they may or may not be tender, and finger contractures have not developed yet. As the disease progresses, the nodules coalesce to form bands or lines of scar tissue (known as "cords").  These are often mistaken for the deeper located tendons in the hand, but are actually quite superficial, laying right below the skin of the palm. The ring and little fingers are most commonly affected, although any digit may be involved. Over time, the fibrous tissue contracts and causes affected fingers to be permanently drawn or curled into the palm, which is known as a flexion contracture (see below).

Fig 3. Dupuytren's disease progression is illustrated showing development of nodules and cords, which eventually progresses to Dupuytren's contracture of the affected digit.

Patients suffering from Dupuytren's disease may experience pain. If not painful and not causing mobility issues, treatment may not be required at that time. Patients with advanced disease are typically plagued by limitations in their activities of daily living and decreases in their overall quality of life. Treatment is beneficial for those patients suffering from advanced disease with painful symptoms and mobility issues.

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Additional Information

Please see the provided Additional Links and Resources about Dupuytren's Disease for additional information and references.