Dupuytren’s Contracture

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Clinically Relevant Anatomy

Dupuytren contracture is a progressive disease of the palmar fascia which results in shortening, thickening and fibrosis of the fascia and aponeurosis of the palm. The palmar fascia is continuous with the antebrachial fascia, the deep fascia of the forearm, and the layer of fascia that covers the dorsum of the hand. The palmar fascia is thicker in the center of the palm and fingers where it forms the palmar aponeurosis and digital sheaths, respectively. The palmar aponeurosis covers the soft tissues of the palm and long flexor tendons. As the longitudinal bands of the palmar aponeurosis undergo fibrosis, the metacarpophalangeal and proximal interphalangeal joints get pulled into flexion. The fouth metacarpal is most commonly affected, followed by the fifth, third, and second. Recently, Dupuytren disease has become a more widely adopted term than Dupuytren contracture to name this condition, as the fingers are not always held in a fixed flexion deformity.1

Clinical Presentation

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