Dupuytren’s Contracture

What is Dupuytren’s Contracture?

Dupuytren’s contracture is a rare hand deformity in which the connective tissue under the skin of your palm, called the superficial palmar fascia, tightens, contracts, and toughens. The reason this occurs remains unknown however its more common in people of Northern European descent. (The same fascia tightness can also occur on the feet and is called Ledderhosen Disease). Eventually, your fingers are drawn down into a bent position. The affected fingers can’t be straightened and it makes using your hand very difficult. Many people come into Dr. McClellan’s office complaining of “bumps in the palm”, “difficulty putting on gloves” or “loss or hand function”.

How is the surgery for Dupuytren’s done?

Here is a live surgerical example of Dr. McClellan performing a Dupuytren’s excision from the palm of the hand. The surgery is performed under general anesthesia at Mon General Hospital  in Morgantown West Virginia.

How do I know if I have Dupuytren’s Contracture?

In order to properly be diagnosed with Dupuytren’s contracture you should seek medical advice. Depending on your health care coverage, you may need a referral in order to be seen by Dr. McClellan. Here is a brief list of some of the more common traits that indicate this deformity:

  • Lumps or bulges in your palm
  • Fingers drawn down into a bent position
  • Inability to straighten your fingers
  • The most commonly affected fingers are the thumb or small fingers (pinky)

What causes Dupuytren’s Contracture?

Dupuytren’s contracture happens when the fascia, or layer of tissue under the skin, of the palm shrinks and pulls your skin and fingers down. There is no known cause for Dupuytren’s contracture; however, it is most common in people that have Northern European or Scandinavian ancestry. Because it seems to be genetically predisposed to happen in individuals, it often runs in families. It is also associated with smoking, drinking, and certain medical conditions like diabetes, thyroid problems, and seizures. It occurs most often in older individuals.

How can Dupuytren’s contracture be treated?

Surgery is the most common treatment for Dupuytren’s contracture. Zigzag-shaped, “Brunner” incisions are made on the palm and the abnormal tissue is removed. This procedure could require skin grafts or other actions to correct the stiffness of the skin on the palm. Unfortunately, the longer that your joints have been “locked” in the bent position, the less likely that they will be able to completely straighten following surgery. So its best to see the Dr. McClellan when you can’t put your hand flat down on the table or there is any bending of the middle knuckle.

Contact our office for more information.

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