What Happens
Dupuytren's
disease is often not noticed until it becomes severe. The tissue between
your skin and tendons, known as the palmar fascia, becomes abnormally thick and
fibrous. It is not yet clear what causes this thickening.
There
are three general phases of the disease:
- Early. You may notice a
small knot on the palm or at the base of the fingers. There is no pulling or
contracture between the fingers and the
palm.
- Active. Dimpling appears on the skin
of the palm due to the growth of the thickened palmar fascia. Long, ropelike
cords and bands also develop in the fascia, stretching from the palm to one or
more fingers. The cord can sometimes be seen and felt.
- Advanced.
The thickened palmar fascia and cord cause a rigid, disabling
contracture
when the attached finger is drawn towards
the palm. Eventually you will not be able to flatten your palm on a table or
other even surface. Very severe forms of the disease result in an inability to
do routine tasks, such as using silverware.
The disease usually progresses slowly. It most often occurs
after age 50. Many people have a mild form that does not cause significant
problems. But a rare form called Dupuytren's diathesis occurs at an early age
and progresses rapidly.
Dupuytren's disease often develops in
both hands of people with the condition, and it most commonly affects the ring
and small fingers.
The goal of surgery for Dupuytren's disease is
to control the disease and to restore use of the fingers. Even with successful
surgery, thickened palm tissue may develop again in the same place or in a new
area of the hands. To get hand function back, reoperation is necessary for some
people.