Hard Swelling on the Palm – Dupuytren’s Disease

Dupuytren’s contracture is a disease that manifests itself as a hard swelling in the palm. If it progresses, the fingers may be bent towards the palm and cannot be fully opened. It may also be called palmar fibroma or palmar fibromatosis.

Dupuytren’s disease or contracture most commonly affects the little finger and ring finger, but can also occur in other fingers. It pulls towards the palm at the joints of the fingers close to the palm. It can be felt as a hard swelling in the palm; This swelling is a nodule caused by the disease. Different treatment methods are applied according to the severity of the nodules.

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Dupuytren’s Disease Symptoms

This disease usually has a slow course. It progresses over months or years. The first symptom is thickening and hardening of the skin in a certain area of ​​the palm. It can be described as a lump, swelling, or nodule; There may be small pits near the nodule. The swelling is firm to the touch but usually not painful.

Over time, the hard connective tissue expands from the nodule to the surrounding area. It usually extends to the little finger and ring finger, but can involve any finger. These bands become increasingly tight, causing the fingers to be pulled towards the palm. Fingers cannot be straightened. Permanent restriction in the joints is called contracture.

Duputren’s contracture can occur in both hands simultaneously. It usually affects one hand more than the other. Due to this disease, the person may have difficulty in opening his hands, grasping things, washing hands and shaking hands.

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What Causes Dupuytren’s Disease?

The cause of this problem is not fully known. But it is more common in some people. It is more common in men between the ages of 40 and 60. It is 4 times more common in men than women. It may show familial transmission; Those who have relatives with this disease are more likely to develop the disease. The risk is increased in diabetics, smokers and alcohol users, thyroid diseases, and epilepsy. However, occupations and injuries with excessive use of the hands do not increase the risk of Dupuytren’s disease.

How Is It Diagnosed?

The doctor will examine your hands for nodules and tight bands. It can control features such as grip strength, finger grip strength, and hand feel. In the so-called desktop test, he may ask you to place your palm flat on the table. In Dupuytren’s contracture, the hand cannot be placed flat on the table. Finger joint range of motion, nodule location and number can be noted. Thus, it can be compared whether there is a change in the next examination.


Complaints can be reduced in the early stages of the disease by methods such as stretching the fingers from the palm outward, massage and hot application. If there is pain, it may be helpful to wear protective gloves and avoid over-squeezing the hands.

There is no cure for Dupuytren’s contracture. However, injection or surgical methods are applied in diseases that are advanced enough to prevent the use of hands in daily work. In the needling technique, tense bands are broken with a needle. The disease tends to recur. Needling treatment can be done again when the bands reappear. If the bands are close to the hand nerves, needle treatment cannot be performed. Corticosteroid and local anesthetic injections can be made. There are also special needles that contain the enzyme called collagenase that breaks down the connective tissue. In advanced disease, the tissue causing the problem can be removed with surgery. After the operation, physical therapy is required in order for the hand to regain its former function.

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