Dupuytren's Disease: What Happens

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What Happens

Dupuytren's disease is often not noticed until it becomes severe. The tissue between your skin and tendons, known as the palmar fascia, becomes abnormally thick and fibrous. It is not yet clear what causes this thickening.

There are three general phases of the disease:

• Early. You may notice a small knot on the palm or at the base of the fingers. There is no pulling or contracture between the fingers and the palm.
• Active. Dimpling appears on the skin of the palm due to the growth of the thickened palmar fascia. Long, ropelike cords and bands also develop in the fascia, stretching from the palm to one or more fingers. The cord can sometimes be seen and felt.
• Advanced. The thickened palmar fascia and cord cause a rigid, disabling contracture when the attached finger is drawn towards the palm. Eventually you will not be able to flatten your palm on a table or other even surface. Very severe forms of the disease result in an inability to do routine tasks, such as using silverware.

The disease usually progresses slowly. It most often occurs after age 50. Many people have a mild form that does not cause significant problems. But a rare form called Dupuytren's diathesis occurs at an early age and progresses rapidly.

Dupuytren's disease often develops in both hands of people with the condition, and it most commonly affects the ring and small fingers.

The goal of surgery for Dupuytren's disease is to control the disease and to restore use of the fingers. Even with successful surgery, thickened palm tissue may develop again in the same place or in a new area of the hands. To get hand function back, reoperation is necessary for some people.

Last updated:	March 31, 2008
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	William M. Green, MD - Emergency Medicine, David Pichora, MD, FRCSC - Orthopedic Surgery
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC