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Dupuyren’s contracture is a genetic condition stemming from the Vikings. The condition involves the build-up of very thick scar tissue in the palm of the hand that grows towards the fingers, which tends to curl up the fingers. The condition is still poorly understood, and what we do know at the moment is that it is a genetic condition with some environmental factors that switch on these genes leading a very thick scar tissue build-up that grows on the normal scaffolding of the connective tissue which connects the skin to the deep structures of the hand. This condition can become very disabling as the thick scar tissue grows towards the fingers and then contract like a muscle, and closes the fingers into the palm making it very difficult to open the fingers and clearing the palm.

The pathological process involves the myofibrocytes, and essentially what happens is, there is a secretion of collagen type III that is seen in mature scar tissue.  This collagen III then grows down the normal scaffolding of the hand, and in the later stages of the disease it tends to contract like a muscle cell.

The treatment of this condition is usually conservative in the early stages, especially if the hand can still go flat on a hard surface. Later on, when there is secondary deformities, my suggested treatment is to do an excision of the diseased tissue in what is called a fasciectomy. When there are existing deformities, and the finger is curled up, we might need to do a lengthening of the skin in a longitudinal plane with a Z-plasty, and/or in advanced cases we may have to do a soft tissue reconstruction in the form of a skin graft.

Dupuytren’s is still a poorly understood condition. What we do know is that the condition tends to be aggressive in patients, especially males with a strong family history. The advised approach to this is to have it seen to by a hand surgeon sooner rather than later. Generally, it is best to treat this before advanced deformities develop.

Please feel free to contact us if this is a condition that you are suffering from, or if you know anybody that is dealing with this.