03/02/2026
Dupuytren's contracture is a hand condition where tissue under the palm thickens, forming cords that pull one or more fingers (often the ring and little fingers) into a bent position, making it hard to flatten the hand. It starts with painless lumps and progresses slowly over time, with causes linked to genetics, family history, smoking, alcohol, diabetes, and sometimes injury, though the exact reason for tissue thickening isn't fully understood. Treatment ranges from observation to injections or surgery for severe contractures that limit hand function.
Symptoms
Painless, firm lumps (nodules) in the palm.
Dimples or pits in the skin.
Thick cords under the skin extending into the fingers.
Difficulty straightening fingers or laying the hand flat (the "tabletop test").
Contracting (curling) of the ring and little fingers is most common.
Causes & Risk Factors
Genetics: Runs in families, especially Northern European descent.
Environmental: Smoking, heavy alcohol use, diabetes, epilepsy, liver disease, hand injury.
Pathology: Abnormal growth of myofibroblasts in the palmar fascia.
Diagnosis & Treatment
Diagnosis: Usually by physical exam, checking for lumps and contractures, and the tabletop test.
Treatment: Varies by severity, including:
Observation: For mild cases.
Corticosteroid injections: For early, tender nodules.
Collagenase injections: To break down cords.
Needle fasciotomy or surgery (fasciectomy): To release the tight cords in disabling contractures.
