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Clinical Summary

Dupuytren contracture results from shortening and fibrotic changes in the subcutaneous palm tissue and longitudinal bands of the palmar aponeurosis. It may begin as a nodule and then progress to contracture of a finger or fingers. Usually, this is noted at the metacarpophalangeal joint, but the proximal interphalangeal (PIP) or distal interphalangeal (DIP) joint may be involved.

Management and Disposition

Surgery is an effective treatment option when patients lose the ability to extend their fingers. Patient education and referral to a hand surgeon are recommended. Recurrence and development of a contracture in other areas may occur.


  1. The flexor tendons are not involved.

  2. The ring and small fingers are the most commonly involved.

  3. Alcoholic liver disease is associated with an increased risk of development.

  4. Thickening of the plantar aponeurosis may occur in the foot.

FIGURE 12.48

Dupuytren Contracture. This chronic problem is seen at the most common site: the ring finger. (Photo contributor: Alan B. Storrow, MD.)

FIGURE 12.49

Dupuytren Contracture. Note the contracture at the fifth metacarpophalangeal joint. (Photo contributor: Vineet Mehan, MD.)

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