Dupuytrens Disease (or Contracture)
Hand and Finger Procedures & Conditions | Dr. William Van Wyk, DFW Hand Surgeon
Dupuytrens Disease (or Contracture)
Hand and Finger Procedures & Conditions | Dr. William Van Wyk, DFW Hand Surgeon
Dupuytren’s disease (or Dupuytren’s contracture) is an abnormal thickening of the tissue just beneath the skin. This thickening occurs in the palm and can extend into the fingers (see Figure 1). Firm pits, nodules, and cords may develop that can cause the fingers to bend into the palm (see Figure 2), which is a condition described as Dupuytren’s contracture. Although the skin may become involved in the process, the deeper structures—such as the tendons—are not directly involved. Occasionally, the disease will cause thickening on top of the finger knuckles (knuckle pads), or lumps or cords within the soles of the feet (plantar fibromatosis).
Causes of Dupuytren’s Disease
The cause of Dupuytren’s disease is unknown but may be associated with certain biochemical factors within the involved tissue. The problem is more common in men over age 40 and in people of northern European descent. There is no proven evidence that hand injuries or specific occupational exposures lead to a higher risk of developing Dupuytren’s disease.
Signs and Symptoms
Symptoms of Dupuytren’s disease usually include lumps and pits within the palm. The lumps are generally firm and adherent to the skin. Thick cords may develop, extending from the palm into one or more fingers, with the ring and little fingers most commonly affected. These cords may be mistaken for tendons, but they actually lie between the skin and the tendons. These cords cause bending or contractures of the fingers. In many cases, both hands are affected, although the degree of involvement may vary.
Dr. Van Wyk & his staff have been phenomenal!
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I’ve had both my hands operated on due to Dupuytren’s. Dr. Van Wyk and his staff have been phenomenal. Dr. Van Wyk was very informative as well as thorough. Dr. Van Wyk and his staff made me feel comfortable and confident in every step of the procedure. Thank you Dr. Van Wyk, Danielle and staff for everything you do.
The initial lumps may produce discomfort that usually resolves, but Dupuytren’s disease is not typically painful. The disease may first be noticed because of difficulty placing the hand flat on an even surface, such as a tabletop (see Figure 3). As the tissue thickens and fingers are drawn into the palm, one may notice increasing difficulty with activities such as washing, wearing gloves, shaking hands, and putting hands into pockets. Progression is unpredictable. Some individuals will have only small lumps or cords while others will develop severely bent fingers. More severe disease often occurs with an earlier age of onset.
Dupuytren’s Disease Treatment
In mild cases, especially if hand function is not affected, only observation is needed. For more severe cases, various treatment options are available in order to straighten the finger(s). These options may include needles or open surgery. Your treating surgeon will discuss the method most appropriate for your condition based upon the stage and pattern of the disease and the joints involved. The goal of treatment is to improve finger position and thereby hand function. Despite treatment, the disease process may recur. Before treatment, your treating surgeon will discuss realistic goals, possible risks and results. Specific surgical considerations include the following:
© 2012 American Society for Surgery of the Hand. Developed by the ASSH Public Education Committee
Board Certified Orthopedic Surgeon Specializing in Hand & Upper Extremity Surgery in Fort Worth Since 1977
Dr. Van Wyk is a hand and upper extremity specialist actively practicing in Fort Worth since 1977. Dr. Van Wyk is board-certified in orthopedic surgery and has practiced in that specialty. He passed the added qualification in hand surgery exam and has limited his practice to 100% hand and upper extremity surgery.
In Dr. Van Wyk’s practice, upper extremity surgery refers to the elbow, forearm, wrist and hand. As a hand specialist, he sees approximately 300 hand patient visits per month and performs on average 90-100 surgical procedures per month. Dr.Van Wyk is a member of the American Society for Surgery the Hand, American Academy of Orthopedic Surgery, the American Board of Orthopedic Surgery, Fort Worth-Dallas Hand Association, the American Medical Association, and the Tarrant County Medical Association.
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