Dupuytren’s ContractureDz

ICD-9 Code: 728.6.
ICD-10: M72.0

Definition: Dupuytren’s contracture results from thickening and shortening of the palmar fascia of the hand. Flexion deformities of involved fingers may cause considerable morbidity.

Etiology: The etiology is unknown; it may be familial (autosomal dominant) in as many as 10% of patients.

Demographics: Dupuytren’s contracture may be seen in 3% to 5% of adults. Men are affected approximately five times more frequently than women, and the incidence increases with age. It occurs most commonly in whites, particularly northern Europeans.

Associated Conditions: Dupuytren’s contracture is often seen in those with alcoholism, diabetes, epilepsy, hypercholesterolemia, RA, or reflex sympathetic dystrophy.

Cardinal Findings: Findings may be unilateral or bilateral. In early disease, painless nodularity of the fascia may be mistaken for local tenosynovial swelling. As the disease progresses, classic, thick, cord-like swelling of the fascia that is easily palpable below the thickened and puckered dermis. The fibrotic process can extend to involve the digital fascia. Shortening of the fascia results in flexion contracture of the fingers, particularly the fourth finger, although digits two through five may also be involved.

Therapy: Physical therapy and local therapies, such as heat, are often recommended for patients with mild contracture. Intralesional corticosteroids injections have varied success. More severe cases may require surgical release of the contracture.

BIBLIOGRAPHY

Thurston AJ. Dupuytren’s disease. J Bone Joint Surg Br 2003;85:469–477.PMID:12793547