Dupuytren's contracture most often affects the ring or little finger, sometimes both, and often in both hands. The condition is noted to be secondary to an increase in fibroblast density – a complex biochemical and cellular interaction. The disorder may occur suddenly but more commonly progresses slowly over a period of years. The disease usually doesn't cause symptoms until after the age of 40.
The condition commonly first shows up as a thick nodule (knob) or a short cord in the palm of the hand, just below the ring finger. More nodules form, and the tissues thicken and shorten until the finger cannot be fully straightened. Dupuytren's contracture usually affects only the ring and little finger. The contracture spreads to the joints of the finger, which can become permanently immobilised. You will lose control of bending and straightening your finger as the disorder develops and the palmar fascia contracts, or tightens. The contracture is like extra scar tissue just under the skin. Without treatment, the contracture can become so severe that you cannot straighten your finger, and eventually you may not be able to use your hand effectively.
If your symptoms are painful or you are having problems performing daily activities due to your Dupuytren’s there are several treatments available such as Collagenase injections. Collagenase Clostridium Histolyticum injection is a fairly new drug that can be injected into the bands of tissue. This drug actually reacts with the fibrous collagen in your hand to break up the tissue. Twenty four hours following your injection you will visit your surgeon who will straighten and stretch your bent finger(s). If unsuccessful the injection can be repeated up to three times. The side effects of collagenase injections can include swelling, bruising, bleeding and pain.
If your fingers cannot be straightened using any other non-surgical treatments your surgeon may recommend surgical correction by performing a Dupuytres Fasciectomy.