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What You Need to Know About Dupuytren's Contracture

What You Need to Know About Dupuytren's Contracture

Having problems with your hands? Learn about the symptoms, diagnosis and treatment of this frustrating condition.

You've noticed something lately. You can't seem to straighten out your ring finger, and your pinky is beginning to curl, too. It doesn't hurt, necessarily, but you're having trouble putting your gloves on. And shaking hands is getting a little harder every day.

Does this sound familiar? If so, you might be developing a condition called Dupuytren's contracture. It happens when lumpy nodules form under the skin inside your hand. Eventually, they merge into cords that pull your outer fingers downward, reducing your hand's movement, as well as its ability to grasp items. Simply swinging a hammer or picking up a book may become difficult. It isn't life-threatening, but it is annoying, and can affect your day-to-day function

What are my chances?                                 
Anyone can develop Dupuytren's contracture in one or both hands, and it's believed to affect between 4 and 6 percent of Caucasians. Though no one knows what causes it, genetics are thought to play the largest role, as the condition tends to be passed down through generations.

These factors also affect your odds:

  • Gender: Men are about three or four times more likely to have it than women, and their cases are typically more severe.
  • Age: Chances increase with as you get older, and most diagnoses occur after age 50. Children under 10 are very rarely affected.
  • Heritage: Scandinavians and Northern Europeans are at a much higher risk than Asian, African and Hispanic people.
  • Diabetes and epilepsy: Evidence is mixed, but these may be linked to a higher risk.   
  • Smoking and drinking: Both are possibly associated with increased chances.

While some believe hand injuries trigger Dupuytren's contracture, there is debate among experts as to whether that's true. More research is needed for a definitive answer.

How about diagnosis and treatment?
Diagnosing Dupuytren's contracture is simple; you don't need blood tests or a drawn-out exam. Your doctor will check your hand for nodes, and then ask you to flatten it on a table. If you're able to do so, you're probably in good shape. If you fingers don't rest flat against the surface, there's a good chance you might have the condition.

Once you've been diagnosed, your doctor will discuss what to do. A mild case of Dupuytren's contracture may not need to be addressed at all—you'll just keep an eye on it in case it gets worse. More serious cases could require treatment to restore movement in your hand. These involve:

  • Needling/Needle aponeurotomy: Your physician punctures the cord(s) in your hand with a needle, breaking it up and restoring finger movement.
  • Steroid injections: Steroids are injected into your hand to slow the condition's progress.
  • Enzyme injections: An enzyme is injected into cords to weaken them. In the days following, a doctor tries to straighten your fingers manually.
  • Surgery: For severe cases that can't be treated otherwise, you can have surgery to remove the affected tissues. It restores movement more completely, though it requires physical therapy afterward.

Despite this range of options, Dupuytren's contracture has no permanent cure, and there's a good chance it will come back. That's why it's important to watch for symptoms, and contact your doctor if the signs reappear.

Medically reviewed in October 2018.

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