Palmar fibromatosis (Dupuytren’s contracture) is a condition in which tissue in the palm of the hand covering the finger tendons thickens and scars. The affected tissue, called the palmar fascia, becomes tight and shortened, contracting the fingers inwards toward the palm.
The development of the condition usually occurs quite slowly over many months, or even years, though in rare cases it can develop suddenly. It can affect any of the fingers, but it most commonly affects the ring finger (fourth digit) and little finger (fifth digit). It can occur in only one hand or in both hands at the same time.
Once palmar fibromatosis progresses to a point where the condition is limiting or disabling, surgery is usually recommended. The surgical procedure is known as a “fasciectomy” and involves making an incision in the skin of the palm above the affected area - often in a zig-zag pattern. The scar tissue is exposed and removed, releasing the tendons and allowing the fingers to move normally. This is a relatively simple and highly successful procedure and is usually performed under a local anaesthetic or nerve block that numbs the arm.
Surgery is followed by a period of recovery and rehabilitation. The time required for this will vary between individuals. It may be necessary to wear a bandage, cast or splint for a short time after surgery. Physiotherapy and an exercise programme (hand therapy) may be recommended to help restore finger mobility and function.
There is a possibility that the condition can recur after it has been surgically corrected. This tends to be related to the age of onset - the earlier the condition develops in life the more likely it is to recur.