Dupuytren’s contracture, also known as palmar fibromatosis, is a common genetic condition that mostly affects older adult Caucasian males, although anyone can develop it. It causes the tissue under the skin of the hand to gradually tighten and thicken, usually around the pinky and ring fingers. Over time, it could permanently bend one or more fingers toward the palm, which can make it very complicated to do everyday movements like shaking hands.
Despite the common occurrence of Dupuytren’s contracture, many people have never even heard of it. This is because it is not typically obvious unless a person attempts to open their hand. Additionally, it is a condition that progresses slowly with little or no pain. It is not uncommon for it to be misdiagnosed as tendinitis or arthritis. There is evidence that patients with Dupuytren’s contracture have a higher risk of various cancers, heart disease, and early death, although the reasons for this are unknown.
Besides causing the permanent bending of fingers towards the palm, patients may also notice a lump forming in the affected area. Otherwise, there are usually no other symptoms.
Dupuytren’s Contracture is a relatively rare condition that affects the hand. It begins as the thickening of an area of tissue underneath the skin of the hand, usually in the palm. This thickening then hardens into bumps and cords that pull on the tendons of the fingers, pulling them in toward the palm. It typically affects the fourth (ring) and fifth (pinky) fingers. The direct cause of Dupuytren’s Contracture is unknown, but there are known risk factors. It affects mostly men over the age of 50. It appears disproportionately in men of Northern European descent and also seems to run in families. Some environmental factors that have been linked to the development of Dupuytren’s Contracture, particularly to men who are predisposed to its onset, are the use of alcohol and tobacco. Patients suffering from diabetes have also shown an increased risk of developing the condition. There is also some evidence that certain medications used to treat epilepsy may activate the onset of Dupuytren’s Contracture.
Presently, treatments exist for the deformities that are caused by Dupuytren’s contracture but not for the process of the condition itself. Both surgical treatments and minimally invasive procedures are available, and the one that is used depends on personal choice of the patient.
Surgical options involve making cuts in the affected skin to either release or remove the contracture. These slits can either be stitched or left to heal at their own pace. Severe cases may require skin removal or skin graft in the palm. Less invasive options consist of releasing tension either with incisions made under the skin or injections formulated to weaken the tissue. Surgical procedures tend to last longer than other treatments.
In terms of prevention, the genetic factors that contribute to the development of Dupuytren’s Contracture cannot really be mitigated. Gender, age and ancestry cannot be prevented or controlled. However, some of the other risk factors or behaviors can be prevented and perhaps help the patient avoid Dupuytren’s Contracture altogether. Should the patient suffer from epilepsy, researching which medications have been linked to Dupuytren’s Contracture and making other choices could be helpful. Maintaining a healthy lifestyle including a balanced diet and regular exercise are essential to prevent the onset of diabetes, which has been linked to Dupuytren’s Contracture. As part of that healthy lifestyle, avoiding use of tobacco and excessive alcohol intake can also be preventative for Dupuytren’s.