In Dupuytren's (say "duh-pwee-TRAHNZ")
disease, tissue under the skin in the palm of your hand, called the palmar fascia, gets thicker and shorter. This can cause your fingers to bend in toward your palm. It most often affects the ring and small fingers, usually of both hands.
The disease may only involve the palm and never affect your fingers. If it gets worse, it may be hard to
use your hands.
Dupuytren's disease is also called Viking's disease.
What causes it isn't known, but your risk of having Dupuytren's is increased if you:
The disease has three general phases:
In most cases, Dupuytren's doesn't cause pain. You may not even notice it until you develop a contracture.
The disease usually gets worse slowly. In many people, it never causes major problems.
A physical exam and medical history will usually give enough information for a doctor to decide if you have Dupuytren's disease. Your doctor will:
The goal of treatment is to keep your hand working as well as it can. You may not need treatment unless you have a contracture. Treatment options include:
The surgery most often done for a contracture is called a fasciectomy (say "fash-ee-ECK-tuh-mee"). The surgeon removes the thick tissue under the skin of the palm. A skin graft may be done to cover open areas in the palm. After surgery, you will need to follow a program of hand exercises and massage to help you move your fingers again.
Your hand may work better after surgery, but you may not get back the full use of your hand. And even when surgery is successful, Dupuytren's comes back about half the time. So you might need another surgery later.
If your symptoms are mild, you can try gentle stretching exercises and massage. There isn't much evidence that they reduce symptoms or slow the disease, but they are easy to do. And they may help keep your hand flexible.
You can also try to avoid curling your hand tightly. For example, you can use utensils and tools that have larger hand grips.
Health Tools help you make wise health decisions or take action to improve your health.
Learning about Dupuytren's disease:
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
ASSH is a professional organization of hand surgeons
that provides education to the public about hand problems, such as Dupuytren's
disease, carpal tunnel syndrome, and tennis elbow. ASSH also provides education
about surgery, preventive tips to keep your hands safe, and an online tool to
find a hand surgeon.
Other Works Consulted
Hertling D, Kessler RM (2006). Dupuytren's contracture section of Wrist and hand complex. In D Hertling, RM Kessler, Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods, 4th ed., pp. 421–422. Philadelphia: Lippincott Williams and Wilkins.
Hurst LC, et al. (2009). Injectable collagenase clostridium histolyticum for Dupuytren's contracture. New England Journal of Medicine, 361(10): 968–979.
Townley WA, et al. (2006) Dupuytren's contracture unfolded. BMJ, 332(7538): 397–400.
March 12, 2013
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Herbert von Schroeder, MD, MSc, FRCSC - Hand and Microvascular Surgery
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