An inherited disease of progressive fibrous tissue contracture of the palmar fascia.
Predominantly affects men of northern European descent >40 years old who smoke, drink alcohol, or have diabetes.
Patients present with a small lump or multiple lumps with pits in the palm of the hand, progressing to contractures of the fingers.
Intralesional corticosteroid injections have been shown to reduce the need for surgery.
Surgical referral should be made when metacarpophalangeal joint contractures reach 30°, or if any degree of proximal interphalangeal joint contracture is present.
Percutaneous needle fasciotomy and collagenase injections are significant therapeutic alternatives to surgery.
An inherited disease of progressive fibrous tissue contracture of the palmar fascia, Dupuytren contracture is seen predominantly in men of northern European descent aged >40 years. Its inheritance pattern is believed to be autosomal dominant with variable penetrance.
History and exam
Thomas H. Trojian, MD, CAQSM, FACSM
Chief, Division of Sports Medicine
Department of Family, Community & Preventive Medicine
Drexel University College of Medicine
THT declares that he has no competing interests.
Craig M. Rodner, MD
Department of Orthopaedic Surgery
University of Connecticut Health Center/New England Musculoskeletal Institute
CMR declares that he has no competing interests.
Professor Thomas H. Trojian and Dr Craig M. Rodner would like to gratefully acknowledge Dr Daniel M. Avery, a previous contributor to this topic. DMA declares that he has no competing interests.
Carlos Wigderowitz, MD, PhD, FRCSEd
Senior Clinical Lecturer in Orthopaedic and Trauma Surgery
Department of Orthopaedics and Trauma Surgery
CW declares that he has no competing interests.
Bill Townley, MD
Salisbury District Hospital
BT is an author of a reference cited in this topic.
Zhongyu Li, MD
Wake Forest University Baptist Medical Center
ZL declares that he has no competing interests.
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