Dupuytrens Contracture

Hand therapy with putty

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What Is Dupuytren’s Contracture? 

Dupuytren’s Contracture Is an abnormal, gradual thickening of the tissue that lies just under the skin on the palm of the hand. The thickening develops into nodules and cords, limiting a person’s ability to open the hand or rest their hand flat on a table.  

Who Does Dupuytren’s Contracture Affect? 

Dupuytren’s Contractures more prominently and more severely affect white males of Northern European descent. It has been shown to run in families with an 80% hereditability. Interestingly, it typically affects both hands, but the right hand is affected more than the left.  Contractures are more likely to occur in a person with a pre-existing condition such as diabetes, alcoholism, smoking, seizure disorder, HIV, and/or vascular disease.  

How do I know I have Dupuytren’s Contractures? 

Diagnosis of Dupuytren’s Contractures can be completed through a physical examination. One key indicator is a person’s inability to flatten their hand on a tabletop because of the limited flexibility of the fingers. Observation of cording and nodules in the palm of the hand is also an indicator of Dupuytren’s presents. X-rays may be obtained to rule out other diagnoses such as arthritis.  

What is the treatment or therapy for Dupuytren’s Contractures? 

Conservative treatment for Dupuytren’s contractures is an option for mild cases. Treatment options include implementing a gentle stretching program that can be completed with a custom orthotic. The orthotic would be custom-made by a therapist, positioning the fingers in a comfortable, lengthened position. The orthotic is re-fitted over time to increase finger straightening and lengthening of the tissue in the palm of the hand. A physician may also recommend medicinal options: cortisone or other injections or outpatient procedures.  

For more severe cases of Dupuytren’s contractures, surgery to cut out a layer of tissue called the fascia, that lies under the skin is recommended. This surgery removes cording and nodules and improves the motion of the fingers. In this case, a hand therapist will help with post-operative care following the procedure. Therapy focuses on scar tissue and pain management, regaining motion, gentle strengthening, and educating the patient on a home program.  

Megan Classen, OTD, OTR/L, CLT, CHT