DUPUYTREN'S CONTRACTURE

The French surgeon Dupuytren in 1832 described a flexion deformity of the fingers caused by thickening and shortening of the palmar fascia. The gradual onset of this deformity, with little or no pain, is characterized by the formation of a firm, fixed nodule in the palmar fascia at the linea mensalis, usually near the base of the ring finger. In time the nodule involves the entire palmar fascia, including the attachments to the sides of the fingers, and contracture of the palm and fingers is produced (fig. 1). The skin becomes involved early; it presents a dry, wrinkled, hard and often calloused appearance and is adherent to the hypertrophied fascia. The subcutaneous fat is lost, but the tendons are not involved. The cordlike contracture of the palmar fascia is brought into a tense position when an attempt is made to extend the finger or fingers, and this is often mistaken