bone, joint, and muscle disorders
Dupuytren Contracture
Introduction
Dupuytren contracture is a progressive tightening of the bands of fibrous tissue (called fascia) inside the palms, causing a curling in of the fingers that eventually can result in a clawlike hand. Dupuytren contracture develops in people who are genetically predisposed. Typical symptoms include formation of a nodule in the palm and, eventually, curling in of the fingers. Doctors base the diagnosis on an examination of the hand. Treatment may involve injection of a corticosteroid into a tender nodule or, if the hand is already scarred, injection ofcollagenaseinto a nodule or surgery to correct contracted (clawed) fingers. (See also Overview of Hand Disorders .) Dupuytren contracture is a common hereditary disorder that occurs particularly in men, especially after age 45. However, having the abnormal gene does not guarantee that someone will have the disorder. About 5% of people in the United States have Dupuytren contracture. The disorder affects both hands in 50% of people. When only one hand is affected, the right hand is affected twice as often as the left. Dupuytren contracture is more common among people with diabetes, alcoholism, or epilepsy. The disorder is occasionally associated with other disorders, including thickening of fibrous tissue above the knuckles (Garrod pads), shrinking of fascia inside the penis that leads to deviated and painful erections (penile fibromatosis [ Peyronie Disease ]), and, rarely, nodules on the soles of the feet (plantar fibromatosis). However, the specific factors that cause the fascia of the palm to thicken and curl in are unknown. 