Dupuytren's Contracture
This conditions is when 1 or more fingers bend in towards your palm. There's no cure, but your fingers can be straightened if it's severe. It normally develops over a number of months or years.
Overall prevalence in the UK is about 4%, rising to 20% in those aged over 65 years old.
Risk Factors
Age >40 years old
Males
Genetic history of Dupuytren's
Northern European decent
Diabetes (31% equally between type 1 and 2)
Smokers
High alcohol consumption
Epilepsy
Symptoms
Thickening and pitting of palmar skin
Firm painless nodules fixed to skin and palmar fascia
Cords
Contracture causing flexion deformity of MCP and/or PIP
Treatment
Decision making tool: https://www.england.nhs.uk/personalisedcare/shared-decision-making/decision-support-tools/
Early stages
No treatment necessary
Provide education and explanation of the condition and its progressive nature
Advise to returns if it develops
Later stages - more significant loss of function
Surgical procedures (Needle fasciotomy, Fasciectomy or Dermofasciectomy)
Corticosteroid injections - beneficial for people with more painful nodules.
Differential Diagnosis
Callus
Tumour/Sarcoma (rare)
Ganglion
Inclusion cyst
Trigger finger
Ulnar nerve palsy
Post-trauma
Rheumatoid Arthritis
Osteoarthritis
Volkmann's contracture (claw-like deformity)
1. NICE. (2022), Dupuytren's disease. Available from: https://cks.nice.org.uk/topics/dupuytrens-disease/. [Accessed March, 2023.]