Epidemiology

• Peak incidence: 40–60 years

Etiology

• Risk factors
  • Recurrent trauma (e.g., use of pneumatic tools used in construction, manual labor)
  • Alcohol abuse
  • Liver cirrhosis

Pathophysiology

• Dupuytren contracture (palmar fibromatosis) is a fibroproliferative disorder of the palmar fascia
• Injury (trauma/ischemia) to the palmar fascia triggers myofibroblasts → fibroblast proliferation and collagen (collagen type III) deposition → thickening of the palmar fascia → formation of nodules in the palmar fascia
• The nodules are adherent to the overlying dermis → characteristic puckering of palmar skin

Clinical features

• The 4th and 5th fingers are most commonly involved
• Skin puckering near the proximal flexor crease: earliest sign
• Palmar nodule
• Palmar cords
• Flexion contracture of affected fingers

Diagnostics

Treatment