Dupuytren contracture

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.[1]Hu FZ, Nystrom A, Ahmed A, et al. Mapping of an autosomal dominant gene for Dupuytren's contracture to chromosome 16q in a Swedish family. Clin Genet. 2005;68:424-429. http://www.ncbi.nlm.nih.gov/pubmed/16207209?tool=bestpractice.com