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Title: 60 year old man with a thickened hand nodule

Category: Orthopedics

Keywords: Hand nodules, contractures (PubMed Search)

Posted: 7/9/2022 by Brian Corwell, MD

Question

Answer

Dupuytren disease/contracture: nodular thickening and resultant contraction of the palmer fascia.

Increased in those of Northern European discent

Increased risk over age 50

Increased frequency in those with diabetes and cigarette smoking

 

One or more painful nodules located near the distal palmer crease.

Over a variable amount of time, the nodule progresses to form a taught fibrous cord

This extends from the palm to the digits, generally ulnar sided and typically the ring finger

Can cause flexion contracture of digit at MCP joint

Sensation is normal.

No imaging necessary

Tx:  padded gloves and activity modification for mild disease, steroid injection for moderate disease and surgery when contracture present