Dupuytren's Disease and Contracture

What is Dupuytren's Disease?

Fast Facts About Dupuytren's Disease

• It presents as a thickening of the skin of the palm of the hand.
• It's hereditary (Autosomal dominant), especially of "Viking heritage."
• Most common among middle age (40-60) individuals.
• More common in men (Male: Female ratio is 7 to 1.)
• Typically presents with contracture of the metacarpophalangeal joint (knuckle joint) and proximal interphalangeal joint (one of the joints of the fingers.)

Dupuytren's Contracture of the Ring Finger (Photograph Courtesy of Frank C. Muller, Wikimedia Commons)

Associated Diseases

• Epilepsy (most common)
• Alcoholism
• Diabetes Mellitus
• Smoking
• NOT related to manual work.

When would Treatment be Needed for Dupuytren's Disease?

• When there's contracture of the metacarpophalangeal joint or MP joint of >30 degrees
• When there's contracture of the proximal phalangeal joint or PIP joint
• Nodules alone does not need surgery.

What kind of Treatments Available?

• Collagenase injections
• Needle aponeurotomy or percutaneous Dupuytren's Contracture release in selected patients.
• Selective or Extensive Palmar fasciectomy and Dupuytren's contracture release.

I recommend asking one of your Houston Plastic Surgeons about your Dupuytren's disease if it requires treatment or not.

Emmanuel De La Cruz M.D.

Reference:

Badalamente MA, Hurst LC: Enzyme injection as non-surgical treatment of Dupuytren’s
Disease. J Hand Surg 25A: 629-636, 2000.

Burge P, Hoy G, Regan P, Milne R: Smoking, alcohol and the risk of Dupuytren’s contracture.
J Bone and Joint Surg 79B: 206-210, 1997.

Chammas M, Bousquet P, Renard E, Poirier J- L, Jaffiol C, Allieu Y: Dupuytren’s Disease,
Carpal Tunnel Syndrome, Trigger Finger, and Diabetes Mellitus. J Hand Surg 20A: 109-114,
1995.

Critchley EMR, Valcil SD, Hayward HW, Owan VMH: Dupuytren’s disease in epilepsy. J
Neurol Neurosurg Psych 39: 498, 1976.

Ling RSM: The genetic factor in Dupuytren’s disease. J Bone and Joint Surg 45B: 709, 1963.

Starkweather ICD, Lattuga S, Hurst LC, et al. Collagenase in the treatment of Dupuytren’s
disease: an in vitro stud y. J Hand Surg 21A: 490-495, 1996.