What is Dupuytren's disease?
Dupuytren type diseases or Dupuytren's disease is a benign connective tissue disease of the hand, which does not allow the fingers to be fully extended. It was named after the French surgeon Baron Guillaume Dupuytren, who first described the disease in 1832. He recognised that the problem did not lie in the flexor tendon but above the flexor tendon in the connective tissue. The commonly used term "tendon curvatures" is therefore not correct because the finger does not curve because the tendons shorten, but because the connective tissue grows bigger and blocks the movement of the fingers.
The condition Dupuytren's disease may progress within several months or several years. Over time, the hand function and performance can be affected to such an extent that even simple tasks are possible only with difficulty.
How common is Dupuytren's disease?
Dupuytren's disease occurs predominantly in the north of Europe, less in Southern Europe. There is an increasing accumulation from the age of 50, men are 5 times more frequently affected. In Germany it is estimated that the number of those affected lies between 1.3 and 1.9 million. There is certainly a hereditary component, because in some families with Dupuytren's disease, the disease occurs more often. In 70-80% of all cases both hands are affected.
What are the signs of Dupuytren's disease?
Knotted and stringy hardening can initially be felt in the layer between the skin and the tendons. Generally, there is no pain. Contrary to the common assumption, the flexor tendon is not affected. As the disease progresses, these growths may spread further and the fingers flex even more due to the tension caused by the reduced tissue. This leads to the finger not being able to be fully extended.
With the growth of tissue, the nerves and vessels may be impaired in their function, and there may be a loss of sensation in the fingers or malfunctions in the blood flow. The main problem is that the gripping function of the affected person's hand is severely restricted by the limitation of the finger extension and the affected finger frequently remains fixed on objects.
How does Dupuytren's disease develop?
The exact causes of Dupuytren disease are not yet known today. In addition to a hereditary predisposition, external trigger factors are discussed, such as an injury. But an influence of growth hormones at the cellular level is also assumed. As well as having a hereditary tendency, Dupuytren's disease is also described as having a high occurrence amongst diabetics and epileptics and occuring in connection with excessive alcohol consumption.
At the beginning of the disease, strands and nodular changes form, mostly in the palm. Later, the aforementioned inhibition in extending / flexion contracture of the fingers can be observed. Most often, a Dupuytren's contracture occurs in the little finger and the ring finger; the other fingers, including the thumb, are rarely affected.
Diagnostics & Therapy
For many years, surgery was the only option for patients with contractures of the fingers. Today, however, there are conservative alternatives.
These clinics specialize in the treatment of Dupuytren's disease and diseases of the hand.