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Dupuytren's contracture

Dupuytren's contracture
Morbus dupuytren fcm.jpg
Dupuytren's contracture of the ring finger
Classification and external resources
Specialty rheumatology
ICD-10 M72.0
ICD-9-CM 728.6
OMIM 126900
DiseasesDB 4011
MedlinePlus 001233
eMedicine med/592 orthoped/81 plastic/299 pmr/42 derm/774
Patient UK Dupuytren's contracture
MeSH D004387
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Dupuytren's contracture (also known as Dupuytren's disease, or by the slang term "Viking disease") is a flexion contracture of the hand due to a palmar fibromatosis, in which the fingers bend towards the palm and cannot be fully extended (straightened). It is an inherited proliferative connective tissue disorder that involves the hand's palmar fascia. It is named after Baron Guillaume Dupuytren, the surgeon who described an operation to correct the affliction.

Dupuytren's contracture is treated with procedures to help straighten the fingers, but this does not cure the underlying disease. Contractures often return or involve other fingers.

According to one study, the ring finger is the finger most commonly affected, followed by the middle and little fingers; the thumb and index finger are only rarely affected. Dupuytren's contracture progresses slowly and is often accompanied by some aching and itching. In patients with this condition, the palmar fascia (palmar aponeurosis) thickens and shortens so that the tendons connected to the fingers cannot move freely. The palmar fascia becomes hyperplastic and contracts.

Incidence increases after age 40; at this age, men are affected more often than women. Beyond 80 the gender distribution is about even. In the United Kingdom, about 20% of people over 65 have some form of the disease.

Typically, Dupuytren's contracture first presents as a thickening or nodule in the palm, which initially can be with or without pain. Later in the disease process, there is increasing painless loss of range of motion of the affected fingers. The earliest sign of a contracture is a triangular “puckering” of the skin of the palm as it passes over the flexor tendon just before the flexor crease of the finger, at the metacarpophalangeal (MCP) joint. Generally, the cords or contractures are painless, but, rarely, tenosynovitis can occur and produce pain. The most common finger to be affected is the ring finger; the thumb and index finger are much less often affected. The disease begins in the palm and moves towards the fingers, with the metacarpophalangeal (MCP) joints affected before the proximal interphalangeal (PIP) joints


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