Dupuytren’s contracture

Dupuytrens contracture is the name given to a condition in which part of the palm of the hand, known as the palmar fascia, thickens and contracts over time resulting in shortening of the tendon. The exact cause of Dupuytrens contracture is unknown but it commonly occurs in individuals who suffers with systemic conditions such as diabetes, epilepsy or excessive alcohol intake. There is also a strong genetic association to developing the disease which is most prevalent in men between the ages of 40-60.

Thickening of the palmar fascia can be felt as thickening of the palm of the hand. This most commonly affects the little and ring finger. If the thickening of the fascia becomes more severe, then the affected fingers may be permanently shortened and flexed towards the centre of the palm. Often Dupuytren's contracture is not painful.

You may notice:

• unusual dimples on your palm
• thickening of the skin on your palm
• tenderness around your palm

Dupuytrens contracture can be reliably diagnosed by your doctor or physiotherapist by taking a history of your condition and by conducting a physical examination. The main feature on examination is the familiar thickening of the palmar fascia. Therefore, X-rays and scans are NOT required.

Surgical management

Many cases of Dupuytrens contracture are mild and don’t need to be treated. When Dupuytren’s contracture starts to affect the function of your hand, surgical release is an effective option for individuals who have moderate to severe contracture of their fingers.

The common surgical options are as follows:

Needle fasciotomy

A needle fasciotomy involves a needle being inserted in to the thickened parts of the palmar fascia which is used to divide the contracted tissue. This procedure is performed under a local rather than a general anaesthetic meaning you won’t need to be admitted to hospital.

Open fasciotomy

An open fasciotomy involves the surgeon making an incision in the skin of the hand enabling them to gain better access to the thickened part of the palmar fascia. A blade will be used to cut the contracted cords of the palmar fascia until the fingers are able to extend. This procedure is also performed under a local rather than a general anaesthetic meaning you won’t need to be admitted to hospital.

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