Dupuytren's contracture is a hand deformity that usually develops over years. The condition affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin — eventually creating a thick cord that can pull one or more fingers into a bent position.
The affected fingers can't be straightened completely, which can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands.
Dupuytren's contracture typically progresses slowly, over years. The condition usually begins as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled. A firm lump of tissue can form on your palm. This lump might be sensitive to the touch but usually isn't painful.
In later stages of Dupuytren's contracture, cords of tissue form under the skin on your palm and can extend up to your fingers. As these cords tighten, your fingers might be pulled toward your palm, sometimes severely.
The treatment in early stages is conservative, even local steroid can be applied with variable results in early stages, as the disease advances, then surgically remove the tissue in your palm affected by the disease is required
. The main advantage to surgery is that it results in a more complete and longer-lasting release than that provided by the needle or enzyme methods. The main disadvantages are that physical therapy is usually needed after surgery, and recovery can take longer.
In some severe cases, especially if surgery has failed to correct the problem, surgeons remove all the tissue likely to be affected by Dupuytren's contracture, including the attached skin. In these cases a skin graft is needed to cover the open wound. This surgery is the most invasive option and has the longest recovery time. People usually require months of intensive physical therapy afterward.
If you have mild Dupuytren's contracture, you can protect your hands by:
Avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape
Using gloves with heavy padding during heavy grasping tasks
However, your condition may persist or worsen, despite these precautions.
While you might first bring your symptoms to the attention of your family doctor, he or she might refer you to an Hand surgeon.