It is defined by Dorland as shortening, thickening, and fibrosis of the palmar fascia producing a flexion deformity of a finger. Tradition has it that the disease originated with the Vikings, who spread it throughout Northern Europe and beyond as they traveled and intermarried.
In many cases, a Dupuytren's contracture progresses (gets worse) very slowly, over a period of years, and may remain mild enough that no treatment is needed. In moderate or severe cases, however, the condition makes it difficult to straighten the involved digits.
Injecting a special enzyme, called collagenase, into the hard lumps and cords can soften and weaken them. At a second appointment within the following week, your hand is moved in a way to break up the cords and straighten your finger. This can reduce or even eliminate the contracture for several years.
The cause of Dupuytren's contracture is unknown, but risk factors include advancing age, Scandinavian and Celtic ancestry, and certain conditions such as epilepsy, alcoholism and diabetes. Treatment options include injections of corticosteroids into the palm and surgery.
Dupuytren contracture occurs most commonly after the age of 50. Sex. Men are much more likely to develop Dupuytren than are women. In men, symptoms may be worse and progress more quickly.
Dupuytren's contracture: This form of arthritis causes the tissue beneath the hand to develop nodules in the fingers and palms. These lumps can cause the fingers to stick in place.
Vitamin D deficiency may stimulate fibroblasts in Dupuytren's disease via mitochondrial increased reactive oxygen species through upregulating transforming growth factor-β1.
Over time it can cause 1 or more fingers to curl (contract) or pull in toward the palm. You may not be able to use your hand for certain things. In many cases, both hands are affected. There is no cure, but treatment can improve symptoms.
There are no proven ways to prevent Dupuytren's disease or limit its progress. Hand therapy and rehabilitation using thermoplastic night splints and regular physiotherapy exercises may aid in the postoperative recovery period.
XIAFLEX® is the only FDA-approved treatment for Dupuytren's contracture that doesn't require surgery. It is a relatively new treatment for Dupuytren's contracture. A hand specialist injects XIAFLEX® directly into the cord causing limited mobility in the finger. The enzyme helps release the cord.
XIAFLEX Injections: The University of Michigan is also using a new FDA-approved treatment for Dupuytren's disease: clostridial collagenase (XIAFLEX) injections that destroy the excess collagen causing the thickening and shortening of the tissue.
Inheritance. Dupuytren contracture is usually passed down through generations in families and is the most common inherited disorder of connective tissue. The inheritance pattern is often unclear. Some people who inherit gene changes associated with Dupuytren contracture never develop the condition.
In 10% of the cases with bilateral disease, it started simultaneously in both hands. One woman and two men noticed the first symptom before 10 years of age. In about 50% of the men, the disease started between 40-59 years of age (women 40-69 years).
It's rare in people younger than 40. On average, men develop Dupuytren earlier than women. If the earliest signs of Dupuytren are included, about 1 of 10 Caucasian men in their 50s have Dupuytren. This number rises to 1 of 4 for men in their 70s, and 1 of 10 women in their 70s.
Your hand and fingers may be swollen for the first few days. Most people need pain medicine for about a week after surgery. You may feel numbness or tingling near the cut, called an incision, that the doctor made. This feeling will probably start to get better in a few days, but it may take several months to go away.
Dupuytren contracture progresses through three phases: (1) proliferative, (2) involution, and (3) residual.
However, Dupuytren's can be associated with conditions that cause contractures in other areas of the body, including the: Knuckle pads (Garrod knuckle pads) Soles of the feet (Ledderhose disease) Penis (Peyronie's disease)
Dupuytren disease can be very painful – but the majority of Dupuytren patients have no pain, and the reason for this is unknown. A smaller proportion of Dupuytren patients report pain than patients with other common painful hand conditions such as arthritis.
Dupuytren's contracture does not develop unless you have one of the genes known to cause it. Conditions that can promote the disease in people with one of the genes include diabetes, smoking, use of some anti-epileptic medications, high alcohol intake, high cholesterol, and injury.
Abstract. Dupuytren's disease (DD) is a fibroproliferative disorder affecting the palmar fascia of the hand. Risk factors include diabetes mellitus (DM), whereas a high body mass index (BMI) is associated with a lower prevalence of DD.
Dupuytren nodules have been discovered to contain dense T-cell infiltrates, suggesting it is a T cell-mediated autoimmune disorder.
Early Signs of Dupuytren's Contracture
The skin might appear puckered as knots (nodules) of hard tissue begin to form on your palm. These nodules might feel tender to the touch, but they're usually not painful. The thickening of the skin usually happens very slowly.
It has associations with various diseases. It has increased incidence in alcoholic and non-alcoholic cirrhosis. Bilateral dupuytren's contracture in cirrhosis of liver is a rare finding.