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Carson Robertson
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Dupuytren's contracture

Dupuytren's contracture is a name given to progressive flexion of the little and ring fingers over time. The fingers become harder to straighten out and may become painful to do so. The fingers can be flexed but not straightened. Often bumps can be felt under the skin. There is an increase thickening of the connective tissue that can eventually prevent straightening the fingers. This makes it difficult to perform everyday activities with the hand, such as putting your hand in your pocket or shaking hands.

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Causes and Symptoms of Dupuytren's Contracture

The cause of Dupuytren's contracture is unknown. The thickening of the connective tissue occurs on the flexor tendon, usually of the 4th or 5th digit. At first a thickening of the palm of the hand is noted, and dimples may appear. Eventually a lump on the palm of the hand or finger will be found. It can be sensitive to the touch but rarely is painful. If the condition progresses fibrotic cords can be felt running from the palm of the hand toward the finger tips.

Dupuytren's contracture usually occurs slowly over time. Although it typically occurs in the two little fingers, it can affect the index finger or thumb. It can affect both hands in some cases.

Treatment for Dupuytren's Contracture

Because some cases progress very slowly, some cases are simply monitored by your doctor. In cases that begin affecting every day activity, early treatment consists of increasing flexibility and limiting progression of the contracture. Maintaining flexibility can be done by stretching the fingers back at home.

Office Treatments goals are to break up early adhesion and fibrotic changes. Graston technique and manual therapies have shown success at improving range of motion and decreasing the tendon fibrosis and scar tissue.

If the condition has progressed, more aggressive treatments may be required. Steroid injections or sugery can be performed by an experienced hand specialist, who can discuss all of the options with you.

Dupuytren's Contracture is a rare condition that occurs very slowly over time. Conservative treatment is more successful in early cases than those that have advanced. For more information on Graston Technique treatment and Dupuytren's Contracture see www.grastontechnique.com

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