Table of Contents
Progressive palmar fascia thickening that results in tethering, fixed finger flexion and skin puckering.
Associations
- Family history
- Liver disease/alcohol
- Antiepileptic drugs
- Diabetes mellitus
- As a feature of other collagen tissue disorders (see questions below)
Clinical features
- Fixed flexion of fingers (especially little and ring fingers)
- Thickened palmar fascia
- Positive table top test (functional test)

Management
Non-surgical
- Conservative management if not limiting function
- Splinting and physiotherapy
- Corticosteroid injections
- Collagenase injections (collagenase enzymes break down collagen)
Minimally invasive
- Needle aponeurotomy (parts of contracted cord weakened by needle manipulation)
- Percutaneous fasciotomy (parts of contracted cord weakened by multiple incisions)
- Segmental aponeurotomy (segments of contracted cord removed by small incisions)
Surgical (open)
- Partial fasciectomy (diseased fascia removed)
- Dermofasciectomy (skin also removed and replaced with skin graft) – lowest recurrence rate
Complications of surgical intervention
- Recurrence (50%)
- Bleeding
- Scarring
- Infection
- Neurovascular complications
Other collagen disorders are associated with Dupuytren’s contracture. What are their characteristic features?
Peyronie’s disease
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Ledderhose disease
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Garrod’s disease
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Image reference: Dupuytren’s contracture: 2010 James Heilman, MD, Creative Commons Attribution-Share Alike 3.0 Unported license