Management of Dupuytren's disease--clear advice for an elusive condition

Abstract

Dupuytren's disease is a progressive fibroproliferative disorder of an unknown origin affecting the hands causing permanent flexion contracture of the digits. Significant risk factors for development of Dupuytren's disease include old age, male sex, white northern European extraction, presence of positive family history of Dupuytren's disease, and diabetes mellitus. The disease also seems to deteriorate rapidly in those cases showing young age of onset and additional fibromatosis affecting the back of the hands, soles of the feet and the penis. Although there is no cure, patients with Dupuytren's disease of the hand may gain a significant functional benefit following surgical improvement or correction of the deformity. With realistic expectations, timely and appropriate surgical technique in a specialist centre, and attention to postoperative recovery and rehabilitation (occupational therapy and physiotherapy support), a beneficial outcome can be achieved in most cases.

Figures

Figure 1

Diagrammatic illustration of clinical presentation in Dupytren's disease; from simple nedule to thick fibrous band formation and finally to finger contracture.

Figure 2

Flow chart for managing patients with Dupuytren's disease from diagnosis to treatment.