EDP column by Professor Ketan Dhatariya
“I have difficulty in straightening my little finger due to a band of tissue on my palm that is getting worse. My GP tells me it is because of my alcohol intake. What is this?”
It sounds very much as though you have what is known as a Dupuytren’s contracture. This is due to an abnormal thickening of the tough tissue around the tendons that allow your fingers to grip. Because it occurs in the palm and fingers it can cause the fingers to curl, making it difficult to straighten your fingers. The condition may complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands. It is more common in men than in women and becomes more common with age, usually beginning over the age of 40. It is most common in people of Northern European or Scandinavian ancestry and most often effects the little and ring fingers. In 50% of people both hands are affected, although one is usually affected more than the other.
This condition was first described in 1831 by a French surgeon, Baron Guillaume Dupuytren (1777-1835). No one knows what causes it, but it is known to run in families, or if your job involved repeated trauma to the hand, e.g. using power tools. But this is not always the case, because it can occur in people who have never had repeated damage to the hands. Also, very rarely, it can occur in the soles of the feet. There is a relationship between liver disease (usually alcohol induced) and smoking, but it also occurs in people taking certain medications, or in people with diabetes.
This is not dangerous in any way, but over time it can limit the use of the fingers and hand, and so can be very inconvenient. In the early stages, the condition may be treated with physiotherapy and stretching. Occasionally steroids may be injected into the thickened tissue. But if the condition progresses and the condition limits the normal functioning of the hand, then the treatment of choice is to have an operation top release the thickened tissue.
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