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Medically reviewed by Alan Carter, PharmD. What to know about bicep tears. Medically reviewed by Daniel Bubnis, M. It results from a thickening and scarring of connective tissue under the skin in the palm of the hand and in the fingers.
The condition affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin — eventually creating a thick cord that can pull one or more fingers into a bent position. The affected fingers can't be straightened completely, which can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands. Dupuytren's contracture mainly affects the two fingers farthest from the thumb, and occurs most often in older men of Northern European descent.
A number of treatments are available to slow the progression of Dupuytren's contracture and relieve symptoms. Dupuytren's contracture typically progresses slowly, over years. The condition usually begins as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled. A firm lump of tissue can form on your palm. This lump might be sensitive to the touch but usually isn't painful.
In later stages of Dupuytren's contracture, cords of tissue form under the skin on your palm and can extend up to your fingers. As these cords tighten, your fingers might be pulled toward your palm, sometimes severely. The two fingers farthest from the thumb are most commonly affected, though the middle finger also can be involved.
However, a hand injury or even hand surgery may trigger the condition in individuals with a genetic predisposition. It affects more men than women. The small nodule will remain the same for years or even decades, not causing any problems, and many people will never need treatment. The aggressive form of the disease can be debilitating, limiting the ability to perform everyday activities.
In severe cases, bands of tissue underneath the skin develop into thick cords that contract the fingers, causing them to curl toward the palm.
It most often affects the ring finger and the pinkie, but can affect all fingers, including the thumb. Over time, as the disease progresses, secondary contractures develop in the ligaments and tendons of the fingers, making the condition at least partly irreversible.
An MRI or other imaging studies are generally not needed. For patients with an early manifestation of the disease, such as a small lump in their palm but no noticeable symptoms, the best course of action is to be evaluated by a hand specialist, who can make an accurate diagnosis and record a baseline examination. Patients are generally advised to do nothing about the condition other than return to their physician every three to six months to see if the disease has progressed.
Many will not develop symptoms for years, if at all.
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