Learning Objectives: After reviewing this article, the participant should be able to: 1. Describe the condition of Dupuytren's disease in its various presentations and severity. 2. Describe the pathologic anatomy involved in palmar and digital contractures. 3. Understand recent elucidation of relevant pathophysiology. 4. Be familiar with treatment options and the management of complications.
Summary: Dupuytren's contracture is one of the most frequent conditions seen by practicing hand surgeons. Inherited in an autosomal dominant pattern, the disease is characterized by a nodular thickening of the palmar fascia metacarpophalangeal and proximal interphalangeal joints. Treatment is offered to symptomatic patients with painful nodular or disabling contracture. The most prevalent surgical procedure is limited fasciectomy of the involved abnormal structures. Recurrence is common. New treatments on the horizon include the injection of clostridial collagenase, which is now in U.S. Food and Drug Administration phase III trials.
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