DUPUYTREN'S CONTRACTURE

Dupuytren's contracture is also called Dupuytren's disease or Viking disease. Tissue under the skin of the palm of the hand becomes thicker and shorter. As the tissue gets shorter, it pulls the fingers down to the palm of the hand. It may get to the point that the fingers cannot be used.

The cause of Dupuytren's is not known. It may occur after an injury to the palm of the hand. It tends to be more common in people from northern Europe and in people who have other family members with it. Generally Dupuytren's does not start until the 40's or 50's. Men are more likely to have it and will have the first symptoms earlier than women. People with epilepsy, diabetes, tuberculosis, liver disease, or alcoholism seem more prone to Dupuytren's.

A thickening, or nodule, develops in the palm of the hand near the base of the ring or little finger. Sometimes a pit, or indentation, may form in the palm or on the finger. Other nodules may develop and create a cord, or band, that extends from the palm into the finger. This cord tightens and pulls the finger into a bent position toward the palm causing some discomfort. Pain is not common with Dupuytren's.

It is hard to tell how bad the disease will be or how soon it will cause problems. Any of the fingers may be involved, but it is most common in the ring and little fingers. It is rare for the middle finger to be involved. The tissue may pull the finger into a completely bent position. However, because the tendons that bend the fingers are not affected, the fingers can always be straightened. If the disease gets worse quickly, the fingers can become bent within a few weeks or months. This is rare. It is more common for a finger or fingers to take several years to reach the bent position.

Dupuytren's is more common in the right hand, but may be in either or both hands at the same time. It is very unusual, but sometimes the soles of the feet may be involved. If the soles are involved, it will occur at the same time as the palms. Even less common a few men will have the same symptoms of the penis. When the feet are affected, it is called Lederhose disease. When the penis is affected, it is called Peyronie's disease.

Surgery can correct Dupuytren's contractures. Dupuytren's can return after the surgery, sometimes many years later. For this reason, surgery is only suggested for those people who have pain or discomfort that is extreme or who cannot use their hand. Surgery may also be suggested if it is impossible to place the hand flat on a table.

The cuts from the surgery may be tender for several months. During this time physical therapy may be needed to get the joints working again. A splint may need to be worn at night for 6 to 9 months.

The healthcare provider will want to see anyone diagnosed with Dupuytren's about every 6 months. The provider can then suggest surgery if and when it is necessary. There is no way to prevent Dupuytren's. It may progress very slowly and does not go away. A healthy lifestyle helps to prevent conditions (such as diabetes, alcoholism, or liver disease) that may be a factor in developing Dupuytren's.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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