Dupuytren's contracture

Dupuytren's contracture is a hand condition that gets worse over several years.

If you have Dupuytren's contracture, there is thickened tissue beneath the skin of your palm. Over time, this forces one or more of your fingers to curl up.

It mainly affects your ring and little fingers. It can affect any finger or thumb on one or both hands.

Dupuytren's contracture is named after a French surgeon.

The first sign is one or more small lumps, called nodules, on the palm of your hand. They are not cancerous.

These nodules slowly get bigger and form tough cords of tissue under your skin. These cords can get shorter, which pulls your fingers towards your palm. This can make everyday tasks like dressing or cooking more difficult.

Dupuytren's contracture can affect people in different ways. You might have just the lumps or nodules, but still be able to straighten your fingers. Others find their hand closing up as their fingers get pulled in.

Your hand might get painful or itchy, but this doesn't' happen to everyone.

Dupuytren's contracture occurs when the layer of fibrous tissue in your palm (called the palmar fascia) becomes thicker and tighter than usual.

Dupuytren's contracture seems to be a genetic condition. It runs in families and is more common in people of Northern European or Scandinavian descent.

Dupuytren's contracture is more common in:

• those aged over 40 years
• males
• people with a family history of Dupuytren's contracture
• people with diabetes
• smokers
• people who drink alcohol

If you think you might have Dupuytren's contracture, see your doctor.

Talk to your doctor if your hand is bothering you or you are having difficulty with daily activities. Your doctor might refer you to a physiotherapist, a hand therapist or to a hand surgeon.

A doctor can diagnose this condition by looking at your hands. They might order an ultrasound scan of your hand.

If the condition isn't causing you any problems, you don't need treatment.

If your hand feels uncomfortable or painful, you could try:

• applying gentle heat
• massaging your palm
• doing exercises to bend your fingers away from the palm

You can see a physiotherapist or occupational therapist for advice.

If Dupuytren's contracture is causing serious problems with using your hand and fingers your doctor might suggest:

• Corticosteroid injections to reduce inflammation.
• Injections of a medicine called collagenase, which can help loosen your fingers enough to straighten them.
• Needle aponeurotomy — where your doctor inserts a small needle into different parts of your hand to break up the tissue.
• Fasciectomy — where a surgeon cuts out some of the thickened tissue.

The International Dupuytren Society has information on Dupuytren's contracture and patient forums.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.