3 days ago
Dupuytren's Contracture Progression: What It Looks Like
Dupuytren contracture can appear as painless lumps or nodules under the skin of your hand, but progression over time can cause your fingers to curl in toward your palm.
Dupuytren contracture is a medical condition affecting the palmar fascia of your hand. Fascia is a thin layer of connective tissue found throughout the body. It provides support and protection for your muscles, bones, nerves, and vessels.
In your hand, the palmar fascia is the main layer of fascia in your palm, located just under your skin. It spreads out in an upside-down triangle from the base of your fingers to your wrist.
Dupuytren contracture causes an atypical thickening in the palmar fascia and leads to the formation of rigid, fibrous cords. These thickened areas restrict the natural movement and function of the fascia and can pull your fingers into a bent position.
Not every person diagnosed with Dupuytren contracture will develop a finger curl. The condition follows a path of progression, but it doesn't always lead to severely bent fingers. For some people, Dupuytren contracture might never progress beyond the lump or nodule phase.
The progression of Dupuytren contracture
Several grading and staging systems have been used to track the progression of Dupuytren contracture since the early 1950s, but there's still no universally accepted standard for classification. Doctors typically use three clinical stages to describe a diagnosis, but they may also refer to a staging system first developed in 1968 known as the Tubiana classification.
Who is at risk for Dupuytren contracture?
Around 80% of Dupuytren contracture is attributed to genetics, with many genes contributing in small ways to the overall risk.
People of Northern European descent have a higher risk for Dupuytren contracture, and the condition has also been associated with:
smoking
diabetes
alcohol
aging
low body mass index (BMI)
How is Dupuytren contracture treated?
Doctors treat Dupuytren contracture based on its severity. In its earliest stage, it might not require treatment if it isn't causing any pain or affecting the function of your hand.
As Dupuytren contracture progresses, doctors consider:
Needle aponeurotomy: A minimally invasive procedure that uses a needle to break apart thickened areas of fascia.
Collagenase injections: The injections of an enzyme that dissolves collagen in Dupuytren cords.
Fasciectomy: The surgical removal of affected parts of the fascia.
Dupuytren contracture can't be cured, but treatments can help restore and maintain your hand's function.
The takeaway
Dupuytren contracture occurs when the fascia in your hand starts to thicken and constrict. In its early stages, it can appear as lumps under the skin, puckering, or hard nodules. Over time, Dupuytren contracture can progress to a point where it curls your fingers in toward your palm.
Not everyone will need treatment for this condition if it doesn't cause pain or affect hand function. When treatment is necessary, nonsurgical and surgical options are available.
