Dupuytren's disease is an abnormal thickening of the fascia, or tissue beneath the skin, in the palm of the hand. Patients with Dupuytren's disease will notice palpable nodules and tight cords in their palm and fingers. As Dupuytren's disease progresses, the thickened fascia of the palm will cause the fingers to bend into the palm. This is called a contracture. Dupuytren's disease is typically not painful, although there may be some discomfort as the nodules and cords grow beneath the skin. The direct cause of Dupuytren's disease is unknown, however the disease occurs most commonly in elderly Caucasian men. There is also a genetic component to the disease, and it often may run in families.
Diagnosis of Dupuytren's disease is made by clinical exam and patient history. Prevalence of the disease in relatives may also be significant due to the disease's genetic component. If the patient is not bothered by the contractures then no treatment is necessary. As the contractures in the fingers progress the patient's activities will be limited. At this point surgical treatment of the disease may be required. Surgical treatment typically involves excision of the nodules and cords causing the contracture. The nodules and cords typically envelop nerves and arteries in the fingers. As such, the biggest risk of the surgery is damage to the nerves and arteries, as well as recurrence of the contracture. After the surgery, splinting and physical therapy are required to regain range of motion and maintain improvements in hand function.
