Dupuytren's Contracture

Question 1

What is Dupuytren’s contracture?

Answer 1

• Proliferative connective tissue disorder
• Palmar fascia undergoes hyperplasia
• Normal fascia bands forming nodules and cords

Question 2

Aetiology of Dupuytren’s contracture?

Answer 2

• 1/2 cases are bilateral
• More common in males
• High prevalence in Northern Europe/Scandinavia

Question 3

Primary Dupuytren’s inheritance?

Answer 3

Familial

Autosomal dominant

Question 4

Secondary Dupuytren’s?

Answer 4

• Alcoholic cirrhosis
• Side effects of phenoytoin theraoy
• Diabetics

Question 5

Presnetation?

Answer 5

• Contractures of MCP and PIP joints: commonly ring and pinky
• Proliferation of myofibroblast cells & production of abnormal collagen
• Skin of hand may be adherent to fascia and puckered
• Palpable nodules may be present

Question 6

Treatment of Dupuytren’s?

Answer 6

Surgical treatment offered if contractures interfere with function

• Fasciectomy: remove all diseased tissue
• Fasciotomy: division of cords
• Recurrence in young patients
• Sever contracture may need amputated