Dupuytren Contracture
Medical Author: William C. Shiel Jr., MD, FACP, FACR
What is a Dupuytren contracture?
Dupuytren contracture is a
localized formation of scar tissue beneath the skin of the
palm of the hand. The scarring
accumulates in a tissue (fascia) that normally covers the tendons that pull the fingers to
grip. As Dupuytren contracture progresses, more of the
fascia becomes thickened and shortened. Dimpling and
puckering of the skin over the area eventually occurs.
How fast does Dupuytren contracture develop?
Dupuytren contracture
varies in its rate of progression from minor skin
puckering for many years to rapid contracture (fixed flexed
position) of
fingers.
What are the causes of Dupuytren contracture?
The precise cause of Dupuytren contracture is not
known. However, it is known that it occurs more frequently
in patients with diabetes mellitus, seizure disorders
(epilepsy), and alcoholism.
Dupuytren's contracture can be inherited. In medical
terms, the inherited form of Dupuytren's contracture is transferred in the family
as a so-called autosomal dominant trait with incomplete penetrance and partial
sex-limitation. This means that the gene for Dupuytren contracture is not on an
X or Y chromosome (sex chromosome) but on one of the other 44
chromosomes. Consequently, one version of the gene is enough
to cause the disorder (it is dominant), but not everyone who
has the gene has the disorder (the gene is not fully penetrant) and the disorder is most frequent in males (the
gene expression is partially limited to males).
What are the symptoms of Dupuytren contracture?
Dupuytren contracture initially may cause only a minor
painless lump in the palm of the hand near the base of the finger(s). Dupuytren contracture most commonly affects
the ring (fourth) finger, but it can affect any and all
fingers. Dupuytren contracture can also affect one or
both hands.
As Dupuytren contracture progresses, it can lead to an
inability to fully extend the affected finger from the
flexed position. This can result in a loss of normal
grasping.
Dupuytren contracture is seldom associated with much, if
any, pain unless the affected fingers are inadvertently forcefully hyperextended.
Next: Is Dupuytren contracture limited to the hands? »
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