Question 1

What is Dupuytren's contracture?

Accepted Answer

Dupuytren's contracture (also called Dupuytren's disease) is a progressive condition where thick cords of tissue develop in the palm, gradually pulling one or more fingers into a bent position. Usually affects the ring finger and little finger. It's caused by abnormal proliferation of fibroblasts (connective tissue cells) in the palm fascia, forming thick collagen bands. The condition is genetic and runs in families, particularly in people of Northern European descent. It's sometimes called 'Viking disease' because of its prevalence in Scandinavian populations. About 5-10% of Australian population affected to some degree.

Question 2

What causes Dupuytren's contracture?

Accepted Answer

The exact cause is unknown, but it's strongly genetic with autosomal dominant inheritance. Not caused by injury or overuse - this is a common misconception. Risk factors include: Northern European ancestry, male gender, age over 50, family history, smoking, alcohol consumption, and diabetes. The disease involves abnormal fibroblast activity leading to excessive collagen deposition in the palm. Trigger for disease activation unknown. Some people have 'Dupuytren's diathesis' - younger age of onset, bilateral disease, nodules on knuckles or feet, and family history - which predicts more aggressive disease.

Question 3

Should I have treatment now or wait?

Accepted Answer

Treatment is based on functional impairment, not just the presence of disease. The 'tabletop test' is useful - if you cannot place your hand flat on a table because fingers won't straighten, it's time to consider treatment. Generally, treatment recommended when: MCP joint contracture reaches 30 degrees, any PIP joint contracture develops (these progress and become harder to treat), or when the bent fingers interfere with daily activities. Early treatment is often easier, especially for PIP joint contractures. However, many people with mild disease never need treatment. Discuss with a hand specialist.

Question 4

What's the best treatment option?

Accepted Answer

Depends on your situation. For single, well-defined MCP joint contractures in older patients: needle aponeurotomy is good option (quick recovery but higher recurrence). For most contractures, especially involving PIP joints or in younger patients: limited fasciectomy (surgical removal) provides most durable results (10-20% recurrence vs 50-70% with needle). For severe recurrent disease in younger patients: dermofasciectomy with skin graft (lowest recurrence but bigger operation). Discuss pros and cons with hand surgeon. Consider your age, occupation, disease severity, and how much downtime you can afford.

Question 5

Will it come back after treatment?

Accepted Answer

Yes, Dupuytren's can recur after any treatment because it's a genetic condition affecting your whole palm tissue. Recurrence rates: needle aponeurotomy 50-70% at 5 years, limited fasciectomy 10-20% at 5 years, dermofasciectomy less than 5%. Recurrence more likely with: younger age, bilateral disease, family history, nodules on knuckles/feet, rapid initial progression, smoking, and male gender (Dupuytren's diathesis factors). True recurrence (disease returning in treated area) vs extension (new disease in different area) are both common. Recurrence can be treated again, often with same or different method.

Medical Disclaimer

Dupuytren's Contracture

📖What is Dupuytren's Contracture?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention