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Dupuytren Contracture

Rebecca King, MD, Karl T. Clebak, MD FAAFP and Shawn Phillips, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Palmar fibromatosis; caused by progressive fibrous proliferation and tightening of the fascia of the palms, resulting in flexion deformities and loss of function

  • Not the same as “trig...

DIAGNOSIS

HISTORY

  • Caucasian male aged 50 to 60 years

  • Family history

  • Mild pain early:

    • Begins in palm and spreads to digits

  • Unilateral or bilateral (50%)

  • Right hand more frequent

  • Ring finger or little finger...

TREATMENT

GENERAL MEASURES

  • Physical therapy alone is ineffective:

    • Intermittent splinting is unlikely to be effective.

    • Continuous splinting may help pre- and postop.

  • Follow isolated involvement of palmar...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

Regular follow-up every 6 months to 1 year 

PATIENT EDUCATION

  • Avoid risk factors (alcohol, vibratory exposure, etc.), especially if strong family ...

REFERENCES

1
1 Peimer CA, Blazar P, Coleman S, et al. Dupuytren contracture recurrence following treatment with collagenase Clostridium histolyticum (CORDLESS [Collagenase Option for Reduction of Dupuy...

ADDITIONAL READING

  • Ball C, Pratt AL, Nanchahal J. Optimal functional outcome measures for assessing treatment for Dupuytren’s disease: a systematic review and recommendations for future practice. BMC ...

CODES

ICD10

M72.0 Palmar fascial fibromatosis [Dupuytren] 

ICD9

728.6 Contracture of palmar fascia 

SNOMED

  • 274142002 Dupuytren's contracture (disorder)

  • 203047009 Dupuytren's disease of palm, with contractur...

CLINICAL PEARLS

  • Dupuytren contracture is a fixed flexion deformity of (most commonly) the 4th and 5th digits due to palmar fibrosis. 90% of cases are progressive; not trigger finger, which is due to t...

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