Dupuytren’s contracture is a condition in which fibrous tissue grows in the palm of the hand and attaches to the tendon sheaths, pulling the fingers in toward the middle of the hand.
The layer of tissue that lies beneath the skin in the fingers and the palms of the hands is called the fascia. As the fascia thickens and tightens, the fingers bend toward the palm, and it becomes impossible to extend them fully.
The fibrous tissue can create thickened cords in the palm. It usually affects the fourth and fifth fingers, known as the ring finger and the little finger or pinky, but the thickening can extend into any of the digits, including the thumb.
Other names for Dupuytren’s contracture are Morbus Dupuytren, Dupuytren’s disease, and palmar fibromatosis.
Well-known people with Dupuytren’s contracture include the late former President of the United States, Ronald Reagan, and the pianist Misha Dichter.
Dupuytren’s contracture happens when changes under the skin of the hand pull the fingers in toward each other.
A contracture is an abnormal shortening of tissue that affects the range of motion.
Dupuytren’s contracture is a shortening of the palmar fascia, which is the thin, tough layer of fibrous tissue that lies between the skin of the palm and the underlying tendons, which allow people to flex their fingers.
The symptoms of this condition develop gradually over several years. The first sign is often a tender lump in the palm. There may be some pain at first, but this usually goes away.
Tough bands of tissue may develop, and it will become harder for the individual to stretch out their hand. Although the bands may resemble cords or tendons, the condition does not involve the tendons.
Unusual dimples or lumps may appear in the palm, and the skin may pucker over these.
The contracture will usually pull one or more of the fingers in toward the palm and make it impossible for the person to extend them.
Dupuytren’s contracture can affect one or both of the hands. Less commonly, it may affect the toes, known as Ledderhose disease, or the penis, called Peyronie’s disease.
The condition is not usually painful, but it makes it harder to use the fingers. The symptoms can range from mild to severe.
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Dupuytren’s contracture can affect a person’s ability to carry out daily tasks.
To diagnose Dupuytren’s contracture, a doctor will check the hands for dimples, pitted marks, thickened skin, bent fingers, and lumps, or nodules.
They may ask the person to do a “tabletop test,” which requires them to place their hand flat on the surface of a table with the palm facing down.
If they cannot flatten their hand, it is likely that they have the condition.