What is Dupuytren's disease?
Dupuytren's contracture is a benign condition which causes a
tightening of the tissue beneath the skin of the palm and fingers. It
may simply cause a puckering of the palmar skin or at its worst will
result in permanently bent fingers.
The disease involves a sheet of tissue under the skin called fascia.
The fascia is responsible for holding the skin of your palm and fingers
stable when you grasp objects. Fibers from the fasia run from the palm
through the length of your fingers. In Dupuytren's disease the fasica
contracts. It may only cause a buckling or puckering of your skin or
may progress until your fingers are bent towards your palm. The
thickend fascia, called a cord, feels like a tight band under your
skin extending into your fingers. Dupuytren's contracture does not
cause pain.
Dupuytren's is diagnosed by a hand surgeon based on the appearance
and feel of your palmar tissue NOT by the presence of a bent finger.
There are many causes of a bent finger which are more common than
Dupuytren's contracture.
Why is it called Dupuytren's?
Guillaume Dupuytren (1777-1835) was Napoleon's surgeon, and in his
time was the most famous surgeon in France. In 1831 at the Hotel-Dieu
Hospital in Paris, he performed surgery and then lectured on a
condition causing bent fingers, which since has borne his name.
Dupuytren was not the first to describe the condition. Sir Astley
Cooper published a description of the disease and its surgical
treatment in England nearly 10 years before Dupuytren. Others preceded
him in describing the condition, including anatomist Felix Plater 200
years earlier. Regardless of who described it, it was Dupuytren whose
name finally stuck. The name is commonly mispronouned even in the
medical community. The empahsis is on the first syllable with the
following phonetic spelling: doo-pa-trens.
Educational Animation
What happens if Dupuytren's Contracture is not Treated?
The disease often causes progressive contractures. Involved tissues
become fibrous and rarely may develop cartilage or calcium deposits.
The younger the person is when they first develop Dupuytren's,
the more likely they will need surgery, and the younger the
patient is when surgery is needed, the greater the chance for
recurrence (not due to the surgery, the age of severity is the
prognostic factor). Overall, finger contractures develop in about one
in 20 people with Dupuytren's disease. If finger contractures
develop, eventually, function is lost - but function and dexterity can
be improved with correction of the contractures. Spontaneous
regression is rare. Spontaneous regression of knuckle pads has
been reported in children.
Interesting Fun Facts about Dupuytren's Disease
| James Barrie, author of "Peter Pan"
had a right contracture thought to
be Dupuytren's,
which formed the source material for Captain Hook's
hook.
"Notice how he is concealing his fingers in this picture"
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| The Papal Benediction sign,
with bent ring and small fingers,
may have started with a pope with the condition.
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Last updated 05.12.09