Dupuytren's Contracture

Dupuytren's contracture is a progressive condition in which the connective tissue beneath the skin of the palm thickens and tightens, forming cord-like bands that pull one or more fingers into a bent position. Over time, the affected fingers — most commonly the ring and little fingers — cannot be fully straightened.

Causes and Risk Factors

The exact cause of Dupuytren's contracture is not fully understood, but it has a strong genetic component and is most common in men of Northern European descent over age 50. Risk factors include a family history of the condition, diabetes, alcohol use, smoking, and epilepsy medications.

The condition progresses at variable rates — some patients remain stable for years, while others develop significant contracture over months.

Treatment

Early-stage disease with minimal contracture may be monitored without intervention. When contracture reaches 30 degrees or more at the MCP joint, or any degree at the PIP joint, treatment is recommended.

Options include needle aponeurotomy (percutaneous needle fasciotomy), collagenase injection (Xiaflex), and surgical fasciectomy. Dr. Kinchelow discusses the risks, benefits, and recurrence rates of each approach with patients to determine the best fit.

Common Symptoms

Pitting or dimpling of the palm skin
Firm nodules in the palm
Cord-like bands beneath the skin
Progressive finger bending toward the palm
Inability to lay the hand flat on a table
Difficulty with gripping, shaking hands, or wearing gloves

Treatment Options

Observation for early-stage disease
Needle aponeurotomy (percutaneous fasciotomy)
Collagenase injection (Xiaflex)
Surgical fasciectomy
Dermofasciectomy for recurrent disease
Post-treatment hand therapy and splinting

Ready to Get Help?

Dr. Kinchelow specializes in treating dupuytren's contracture. Schedule a consultation today.

Request Appointment (954) 635-5300