What Is Dupuytren's Contracture (Disease)?

Dupuytren's Disease, as it is called in present day, was first described by French Anatomist and Military Surgeon, Guillaume Dupuytren in 1831. Although the condition is predominantly traced with origin to northern European territories, Dupuytren's Disease is now a world-known condition. Dupuytren's is acknowledged as primarily afflicting men (age 40 and older) of northern European descent; however, in the past decades, there has been increased evidence that the condition can indiscriminately occur in women and individuals of other races and ages.

Dupuytren's Disease results in an abnormal thickening of the fascia (the tissue just beneath the skin of the palm). It often starts with firm lumps in the palm. In some patients, firm cords will develop beneath the skin, stretching from the palm into the fingers (see Figure 1).

Dupuytrens Contracture with Nodules Picture
Figure 1: Picture of Dupuytren's with nodules present, but no contracture.

In some patients, these growths may extend and develop into tight bands or cords, which draw the finger(s) into the palm – preventing the finger joints from extending (see Figure 2). This occurrence is known as a "flexion contracture."

Dupuytrens Contracture with Palmar MP Picture
Figure 2: Palmar Dupuytren's with palmar MP joint contracture.

Although the skin may become involved in the progression of Dupuytren's, the deeper structures (such as the tendons) are not typically involved. Occasionally, the disease will cause thickening on top of the finger knuckles (known as "knuckle pads"), or other nodules or cords within the soles of the feet (known as Plantar Fibromatosis).

In advanced cases of Dupuytren's Contracture, larger areas of the palm and multiple fingers may be involved, resulting in functional difficulties due to inability to open or extend the digits (see Figure 3).

Dupuytrens Contracture Cord Contracture Picture
Figure 3: Severe Dupuytren's cord and contracture.

What Causes Dupuytren's Disease?

The cause of Dupuytren's Disease is unknown, but it is believed to be possibly associated with certain biochemical factors within the involved fascia. The problem is most common in men over age 40 and in people of northern European descent. However, this condition may occur in women or people of any age and race. There is no proven evidence that hand injuries or specific occupational exposures lead to a higher risk of developing Dupuytren's Disease, or progression of pre-existing Dupuytren's Disease.

For additional information regarding Dupuytren's Disease, please visit the various website links listed in the Patient Resources (Useful Links) section of our website.

To learn more about Dupuytren's Contracture and the various treatments to correct it, request a consultation, or contact The Hand & Wrist Center at (562) 424-9000.

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