An inherited disease of progressive fibrous tissue contracture of the palmar fascia. A contracture is a shortening of soft tissue leading to restricted movement.

In DC the finger is tightened into a flexed position and cannot extend.

Dupuytren's contracture is seen predominantly in men of northern European descent aged >40 years. Its inheritance pattern is believed to be autosomal dominant with variable penetrance

Aetiology: Unclear, thought to be an inflammatory process in response to microtrauma

Risk Factors:

• Age >40
• Family history (autosomal dominant pattern)
• Male
• Diabetes (more with type 1, but also type 2)
• Manual labour, particularly with vibrating tools
• Epilepsy - anticonvulsant medications
• Smoking and alcohol

PC

• Palmar nodules - Proximal to MCPJ at distal crease - early sign
• Palmer skin changes - Thickening, theathering, pitting
• Tendinous cords - most commony ring finger
• MCPJ contracture - as cord progresses across the MCPJ, can also progress over the PIPJ

*No associated pain