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Dupuytren's Contracture


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.

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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"

The Papal Benediction sign,


with bent ring and small fingers,


may have started with a pope with the condition.


Last updated 05.12.09

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