Dupuytren’s Contracture

• Dupuytren’s contracture is a condition where the fascia of the hand becomes thickened and tight, leading to finger contractures
• Contracture

  A shortening of the soft tissues that leads to restricted movement in a joint
• In Dupuytren’s contracture, the finger is tightened into a flexed position and cannot fully extend
• Palmar fascia


  Forms a triangle of strong connective tissue on the palm
• Dupuytren’s contracture pathophysiology

  1. The fascia of the hands becomes thicker and tighter and develops nodules

  2. Cords of dense connective tissue can extend into the fingers, pulling the fingers into flexion and restricting their ability to extend (contracture)
• It is unclear why the fascia becomes thicker and tighter. However, it is thought to be an inflammatory process in response to microtrauma
• Risk Factors for Dupuytren’s contracture

  • Age
  • Family history (autosomal dominant pattern)
  • Male
  • Manual labour, particularly with vibrating tools
  • Diabetes (more with type 1, but also type 2)
• The fascia becomes thicker and tighter due to an inflammatory process in response to microtrauma
• Risk Factors for Dupuytren’s contracture

  • Age
  • Family history (autosomal dominant pattern)
  • Male
  • Manual labour, particularly with vibrating tools
  • Diabetes (more with type 1, but also type 2)
  • Epilepsy
  • Smoking and alcohol
• The table-top test is a straightforward test for Dupuytren’s contracture. If the hand cannot rest completely flat on a table, the test is positive
• Management options for Dupuytren’s contracture

  1. Do nothing (conservative management)

  2. Treat it surgically
• Surgical management options for Dupuytren’s contracture

  • Needle fasciotomy (needle aponeurotomy)
  • Limited fasciectomy
  • Dermofasciectomy
• Last updated August 2021
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• Zero to Finals Medical Revision Podcast - Dupuytren’s Contracture
• Audio Player 00:00 00:00 | 04:02 Rewind 10 seconds Speed Forward 30 seconds Info The Zero to Finals Medical Revision Podcast Dupuytren’s Contracture Apr 22, 2022 Season 34 Episode 28 Thomas Watchman This episode covers Dupuytren’s contracture. Written notes can be found at https://zerotofinals.com/surgery/orthopaedics/dupuytrens/ or in the orthopaedic section of the Zero to Finals surgery book. The audio in the episode was expertly edited by Harry Watchman. Share Subscribe Apple Podcasts Spotify More Apple Podcasts Spotify Google Podcasts Overcast Stitcher iHeartRadio TuneIn + Alexa Castro Castbox Pocket Casts Podfriend Goodpods RSS Feed Buzzsprout