Understanding Dupytren’s Contracture

Ryan LaCorte Ashley Intile, Publications

Have you ever noticed a knot or lump located under the skin of your palm, causing your finger to bend inward, making it difficult to complete daily tasks such as buttoning your shirt, wearing gloves or reaching into your pocket? If so, you may be experiencing Dupytren’s Contracture.

What is Dupytren’s Contracture?

Palmar Fibromatosis, commonly known as Dupytren’s contracture, is a progressive condition that affects the layer of tissue that lies under the skin of your palm. The affected tissue called the palmar fascia, which covers the finger tendons thickens and shortens forming knots creating a thick cord that can pull one or more fingers into a bent position. The lumps or knots that form are uncomfortable to some people, however, rarely is it painful. Dupytren’s contracture mainly affects the ring and small finger, followed by the long finger, but it can occur in any digit. In many cases, both hands are affected, but each hand can be affected differently.

Causes and Risk Factors

The cause for Dupytren’s contracture is unknown and there is no cure for this disease, however, the condition usually develops slowly and is non-life threatening. The disease onset is seen in more middle-aged adults. It is shown to be more common in men than women and particularly those of Northern European descent. Certain things may make you more likely to develop Dupuytren’s contracture. They include:

  • Drinking alcohol
  • Diabetes
  • Smoking
  • Seizures
  • Having a family history of Dupytren’s

Signs and symptoms

  • Lumps or knots start to form in the palm. The lumps may be tender to touch.
  • Overtime it may be difficult to lay your hand down flat.
  • Thick cords may develop that feel like they are attached to the skin
  • One or more fingers bending or curling in toward the palm of the hand making it difficult to straighten.

Treatments Options

Occupational therapy can help treat your symptoms conservatively, however, because Dupytrens disease is a progressive disease the contracture cannot be changed unless there is some type of surgical intervention. In severe cases, various treatment options are available to straighten the finger. These options may include needles, injectable medicine, or surgery. After a surgical intervention is performed, occupational therapy is recommended to evaluate your condition, focus on helping individuals to maintain finger extension that was gained through the procedure performed and regaining functional use of your hand. In therapy a treatment plan will be designed specifically for you. The program will include specific therapeutic exercises to treat range of motion and strengthen any areas there may be a deficit. Treatment can include:

  • The therapist can fabricate a custom fabricated splint to the involve finger to maintain finger extension. This splint would be worn during activities throughout the day and at night.
  • Stretching and strengthening exercises in a pain- free range of motion to gain functional use of hand.
  • The therapist may use modalities such as therapeutic ultrasound, scar tissue massage, and moist heat to relieve pain and inflammation.
  • Provide education on adaptive techniques and use of assistive devices to enhance functional abilities.

Dupytrens Contracture can have a significant impact on all your daily activities making them difficult to complete. Addressing this condition early can help slow the progression of the disease and have a better prognosis. At All-Care Physical Therapy, our Hand Therapist specialize in the treatment of Dupytrens and create custom fabricated splints. Contact your physician if you are experiencing these conditions and ask if an Occupational Therapist at All-Care Physical Therapy can help. OT Hand Therapy is currently being practiced in our Toms River (732-505-1300), Whiting (732-849-0700), or Jackson (732-833-1133) locations.

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