Introduction

Dupuytrens contracture (Dupuytren's disease) is a condition that affects the hands and fingers. It causes one or more fingers to bend into the palm of the hand. It can affect one or both hands, and sometimes affect the thumb.

Dupuytren's contracture occurs when the connective tissue in the palm thickens. Often the tissue thickens in one small area first and a nodule forms (a small, hard lump about 0.5-1cm) under the skin of the palm. The nodule sometimes feels tender to begin with, but this usually passes. More nodules may then develop.

The nodules are non-cancerous (benign) and the condition isn't life-threatening for those who develop it, although it can be a nuisance to live with.

Over time, the nodules can extend and form cords of tissue.These cords can shorten (contract) and, if the cords run along a finger or thumb, they can pull it, so it becomes bent towards the palm. These contractures are often mild and painless, but they can get steadily worse over time.

However, it's not clear how significant these factors are.

It can affect both sexes, but affects men more than women.The condition usually occurs during later life, although cases have been reported in children. Most casesoccurin men over 50 and women over 60.

The condition seems to be more common in people of North European descent.It's thought the gene associated with the condition was brought to the UK by the Vikings.

Preventing Dupuytren's contracture

As the exact cause of Dupuytren's contracture is unknown, it may not be possible to prevent the condition.

However, if you're at risk of developing the conditionfor example, if you've had it in the past, or if you have a family history of it stopping smoking (if you smoke) may reduce your risk.

Treating Dupuytren's contracture

Many cases of Dupuytren's contracture are mild and don't need treatment.Treatment may be helpful if the condition is interfering with the normal functioning of your hand.

Non-surgical treatments include radiation therapy and injections with a medication called collagenase.

Alternatively, a minor procedure that involves using a needle to cut the contracted cord of tissue (needle fasciotomy) may be used in the early stages of the condition.

In moresevere cases, surgery can help to restore hand function. The two most common surgical techniques are:

• open fasciotomy where the shortened connective tissue is cut to relieve tension
• fasciectomy where the shortened connective tissue is removed

Surgery for Dupuytren's contracture can't always fully straighten the affected finger or thumb, and the contracture can recur after surgery. If a contracture does recur, further surgery may be possible.

Having surgery to remove the first nodule that appears won't stop the condition from progressing, as this won't stop the condition occurring elsewhere in the palm. It's usually best to avoid surgery until a contracture developsthat interferes with use of the hand.

Trials into other possible treatments are under way.

Dupuytrens contracture often runs in families and genetic research hopes to identify the genes responsible for the condition. This could lead to the development of treatments that prevent contractures occurring in the first place.

Information about you

If you have Dupuytrens contracture, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS).

This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.

Find out more about the register.