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What is Dupuytren's contracture?
Dupuytren’s contracture, also known as Viking’s disease, is a progressive hand condition that affects the connective tissue beneath the skin of the palm and fingers. It is named after Baron Guillaume Dupuytren, a French general and surgeon who first described the condition in the 19th century. Although the condition was found to have existed long before him. In fact, it is believed that the vikings may have been the first to suffer from Dupuytren’s. The condition develops gradually over time and can be more common in men over the age of 50.
What causes Dupuytren's contracture?
While the exact cause of this condition is not fully understood, it is believed to start with an overgrowth of connective tissue in the palm of the hand. Over time, this tissue thickens and tightens, causing the fingers to gradually curl inward. In addition, there are potential genetic and environmental factors that may contribute to its development including pre-existing medical conditions such as diabetes and epilepsy.
- Genetics
- Fibroblast activity
- Collagen accumulation
- Age and gender
- Lifestyle choices
- Ancestry
- Inflammation & immune system
- Other medical conditions
Dupuytren's Contracture Symptoms
How do you know if you have Dupuytren's contracture?
The symptoms of this condition can be subtle at first, with tiny nodules or lumps appearing on the palm of the hand. Over time, these nodules can grow and form cords of tissue that pull the fingers down into a bent position. There are various ways to diagnose Dupuytren’s contracture, ranging from a physical examination to imaging tests like X-rays and ultrasounds. If you suspect you might have Dupuytren’s contracture, it’s important to consult a physician, typically an orthopedic specialist, for an accurate diagnosis. Here are some signs and symptoms to be aware of:
- Palmar Nodules: One of the earliest signs of Dupuytren’s contracture is the development of small, painless nodules or lumps in the palm of your hand. These nodules may feel firm or slightly tender to the touch.
- Cords and Bands: As the condition progresses, thickened cords or bands of tissue may develop beneath the skin of your palm and fingers. These cords can cause your fingers to bend inward, resulting in contractures. The most commonly affected fingers are the ring and little fingers.
- Finger Contractures: The hallmark of Dupuytren’s contracture is the bending or curling of one or more fingers toward the palm. This can limit your ability to fully extend the affected fingers.
- Difficulty in Hand Function: As the contractures worsen, you might experience difficulty with everyday tasks that require a full range of hand movement, such as grasping objects, shaking hands, or putting on gloves.
What aggravates Dupuytren's contracture?
Unfortunately, there are a number of factors that can aggravate Dupuytren’s further. Smoking, diabetes, and drinking alcohol have all been linked to a heightened risk of developing Dupuytren’s contracture, and they can also have an impact on how much the condition affects an individual. Additionally, repeated hand injuries or hand-intensive work may also exacerbate the condition. Even simple repetitive movements, such as typing or playing an instrument, can put added strain on the hand and potentially worsen symptoms.
What does Dupuytren’s contracture look like?
The appearance of Dupuytren’s contracture can vary from person to person, but typically, it is characterized by small, hard nodules or lumps under the skin on the palm.
What does Dupuytren’s contracture feel like?
For those who have experienced it, the sensation is described as feeling like their fingers are getting stuck or caught on something. They may also feel a tightening or pulling sensation in their palm, which can limit their hand’s range of motion. While some individuals may not experience any discomfort, others may also feel mild to moderate pain in the affected area.
Dupuytren’s Contracture vs Trigger Finger
What is the difference between trigger finger and Dupuytren’s contracture?
Trigger finger and Dupuytren’s contracture are two common hand conditions that may seem interchangeable but have distinct differences. While they may exhibit similar symptoms such as limited finger movement and a lump or nodule on the palm or finger, they are different conditions. Trigger finger is a problem with the tendon that causes the finger to lock or catch when trying to straighten it. On the other hand, Dupuytren’s contracture is a condition that causes the tissues of the palm to thicken and shorten, resulting in a curling of fingers towards the palm.
Dupuytren's Contracture Treatment
What is the latest treatment for Dupuytren’s contracture?
While there is no known cure for Dupuytren’s contracture, there are a number of treatment options available to alleviate symptoms and improve hand function. Recently, a new treatment has emerged for this condition in the form of a minimally-invasive procedure called Xiaflex.
Collagenase is an enzyme that breaks down collagen, the protein responsible for the thickened cords in Dupuytren’s contracture. Xiaflex is an FDA-approved medication that contains collagenase and is injected into the cords. It weakens the cord, allowing the doctor to manipulate the finger and break the cord, effectively releasing the contracture.
What happens if Dupuytren’s contracture is left untreated?
While it initially may not cause any pain or discomfort, if left untreated, Dupuytren’s contracture can result in significant limitations of hand functionality. In severe cases, the condition can make it nearly impossible to perform daily tasks like washing dishes or holding objects. Additionally, untreated Dupuytren’s contracture can lead to permanent contractures, which means your fingers may become permanently bent or folded, making it difficult to grasp objects or use your hand at all.
- Decreased hand function
- Difficulty with activities
- Pain and discomfort
- Skin problems
- Secondary deformities
- Functional limitations
What type of doctor treats Dupuytren’s contracture?
A hand or orthopedic specialist is typically the type of doctor who treats Dupuytren’s contracture. These physicians have the knowledge and experience to diagnose and manage conditions affecting the hands and upper extremities. Our team of medical professionals are especially skilled in identifying and treating orthopedic conditions of the hand, wrist, and arm, including Dupuytren’s contracture.
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