Houston Methodist. Leading Medicine

Hand FAQ

Question:

When I was a little boy, I remember visiting my great-grandfather in Scotland. What I remember most was how gnarled his hands were. In fact, he could no longer open his right hand to shake hands with my father. I'm starting to develop some stiffness and difficulty laying my palm flat on the table. Could I be getting the same thing?

Answer:

You may be describing a condition called Dupuytren disease, a fairly common disorder of the fingers. It occurs most often in middle-aged, white men. This condition is seven times more common in men than women. The disorder may occur suddenly but more commonly progresses slowly over a period of years. The disease usually doesn't cause symptoms until after the age of 40. Genetics and gender play significant roles. This condition is seven times more common in men than women. It is more common in men of Scottish, Scandinavian, Irish, or Eastern European ancestry. Researchers agree that genes are not a direct cause of this disease, but predispose someone to this condition. If you have a family member (especially a sibling) with this problem, you are at least three times more likely to develop the problem yourself. The condition commonly first shows up as a thick nodule (knob) or a short cord in the palm of the hand, just below the ring finger. More nodules form, and the tissues thicken and shorten until the finger cannot be fully straightened (called contractures). Dupuytren's contracture usually affects only the ring and little finger. The fact that you can no longer place your open hand flat on the table is an important clue. This is called the table top sign. A positive table top sign points to Dupuytren disease. But there are other possible causes of what you are describing. For example, trigger finger can lock the tendon and keep the finger from moving. It is best to see a hand specialist in order to get a proper diagnosis and treatment. Most hand conditions respond better with early intervention. Waiting until the symptoms are severe increases the risk of a poor result. Eric M. Black, MD, and Philip E. Blazar, MD. Dupuytren Disease: An Evolving Understanding of an Age-Old Disease. In Journal of the American Academy of Orthopaedic Surgeons. December 2011. Vol. 19. No. 12. Pp. 746-757.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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