Dupuytren's Contracture: A Case Review

Dupuytren contracture is a contraction disorder of the hand related to an abnormal myofibroplastic process. An autoimmune response may trigger fibroblasts to proliferate along lines of tension within bands of the palmar fascia and other tissues within the hand resulting in fibrous cords and nodules of the hand. Risk factors include Scandinavian or Northern European descent, trauma, chronic use of vibrating tools, medical disorders such as diabetes, HIV, epilepsy, and vascular disease as well as a social history of smoking or alcoholism. The disorder is relatively painless, and patients tend to delay seeking care until the contracture has progressed to the point of causing some degree of disability or impacting their daily lives. Treatment options include surgical fasciectomy, collagenase injections, or needle fasciotomy followed by occupational therapy interventions such as splinting and stretching. Intervention is generally effective in improving symptoms and functionality; however, recurrence is still possible.