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Dupuytren's contracture

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Contracture of palmar fascia causing the ring and little fingers to bend into the palm so that they cannot be extended.

Description

Contracture of palmar fascia causing the ring and little fingers to bend into the palm so that they cannot be extended. Associated with thickening and nodularity of the palmar connective tissue. All the digits, including the thumb, can be affected, but particularly the ring and little finger. Right hand more frequently affected. Occurs most commonly in males of northern European extraction, usually between the ages of 40 and 60 years, but females and other age group can also be affected. In rare cases, similar contractures may occur on the plantar fascia of the foot. It is a family disorder with a probable autosomal dominant inheritance with variable penetrance.

The condition had previously been described by Sir Astley Cooper, but was first mentioned by the Swiss physician Felix Platter (1536-1614), who worked in Basel.

Bibliography

  • F. Platter:
    Observationum in hominis affectibus. Basileae, L. König, 1614.
    Platter first described flexion contracture deformity of the fingers (Dupuytren’s contracture) in Liber I, page 140. This work also contains the first known report of death from hypertrophy of the thymus in an infant (page 172).
  • G. Dupuytren:
    De la rétraction des doigts par suite d’une affection de l’aponévrose palmaire, opération chirurgicale qui convient dans ce cas.
    Journal universel et hebdomadaire de médecine et de chirurgie pratiques et des institutions médicales, Paris, 1831, 2nd series; 5: 352-365.
    Reprinted, in Medical Classics, 1939, 4: 127-150.
    Translated into English and published in 1833 by Alexandre Louis Michel Paillard (1803-1835) and Edmond Marx (1797-1865). Permanent retraction of the fingers, produced by affection of the palmar fascia.
    Lancet, London, 1833-1834, 2: 222-225.
  • C. Goyrand:
    Nouvelles recherches sur la rétraction permanente des doigts.
    Mem R Méd Belg, 1833, 3: 489.

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