Dupuytren's Contracture (Palmar Fasciectomy)

Dupuytren's contracture is caused by underlying contractures of the palmar fascia. The ring finger and little finger are the fingers most commonly affected. The middle finger may be affected in advanced cases, but the index finger and the thumb are nearly always spared.

Dupuytren's contracture progresses slowly and is usually painless. In patients with this condition, the tissues under the skin on the palm of the hand thicken and shorten so that the tendons connected to the fingers cannot move freely. The palmar aponeurosis becomes hyperplastic and undergoes contracture.

Surgical management consists of opening the skin over the affected cords and excising (removing) the fibrous tissue. The fingers may then be brought out to length with the help of postoperative therapy.