A person’s hands are often taken for granted. These incredible tools help people grasp things and perform tool based jobs that so many mammals can only dream about.
Dupuytren’s contracture is an interesting hand deformity. People with it develop layers of tissue under the skin that pull the fingers down into a grasping.
Like many conditions, Dupuytren’s contracture can take a long time to develop. In most cases it can take years. People may not even realize it for quite a while. If left untreated, the fingers will no longer be able to be bent. Thankfully there are some treatment options that can help people who are suffering from Dupuytren’s contracture depending on how advanced the disease has become.
How it Occurs
The process of how Dupuytren’s grows over the years is quite interesting. In most cases, Dupuytren's contracture affects the fingers on the outside of the hand. It’s usually two fingers. Sometimes it may affect several. The first stage has the skin on the top of the hand thicken on the palm. Eventually this skin looks a bit puckered or like it has some dimples. From there, tissue forms in a lump under the skin. This lump can be painful to the touch, but is usually just a lump.
From there, cords of tissue actually form under the skin from that area up to the affected fingers. The cords grow, then they tighten. It’s this tightening which makes the fingers unable to extend fully and give the claw-like appearance in those fingers. Sometimes the tightening will only pull them a short way, but other times they can be pulled quite severely towards the palm.
People At Risk
Quite simply, there’s no exact known cause for who contracts Dupuytren’s contracture. There are however a large number of risk factors which put certain groups of people at higher risk of developing this condition. Some of the potential risks include:
- Sex - Men are more likely to get Dupuytren’s contracture. It’s almost more likely that they will get more severe contractures and tightening tissue.
- Ancestry - People who can trace their ancestry to Northern Europe are more likely to get Dupuytren’s Contracture.
- Age - Typically this condition only affects people after they turn at least 50 years old.
- Family History - Dupuytren’s contracture tends to run down family trees, so a history in other members of the family suggests an elevated risk.
- Diabetes - Diabetes can be a risk factor that increases a large number of medical conditions including Dupuytren’s contracture.
- Smoking and Drinking - Those people who choose to smoke or drink alcohol are more likely to get Dupuytren’s contracture.
There are different techniques that can be used to try to help people who are suffering from Dupuytren’s contracture. One common option is enzyme injections. This treatment will inject the softening enzyme into the tissue cord in a person’s palm. This should allow a doctor to then move the hand and break the cord, restoring movement to fingers.
Needling is another option and is somewhat similar. Rather than softening the cords, needles are inserted to break up the tissue cords. This is usually the first treatment option as it doesn’t require incisions for surgery and has minimal recovery time to get the hand back to full ability. The biggest downside to needling is that in some cases, it’s possible to damage nerves or tendons in the area. The other downside is that it’s possible for Dupuytren’s contracture to regrow with needling, though this procedure can be used again.
Surgery is really only considered in advanced cases of this disease. It’s for people who have lost a large amount of their hand function. A section of the tissue on the hand is removed completely, along with the tissue cords. It can take time and physical therapy to regain the full use of the hand unfortunately.