Dupuytren's disease

Benign progressive fibroproliferative disorder of the palmar and digital fascia, classified by WHO 2020 as a palmar-type fibromatosis. Characterised by myofibroblast-driven formation of nodules and cords in the palmar aponeurosis, leading to progressive flexion contracture of the digits, most commonly the ring and little fingers.

Related terms

• Anatomy

  Palmar aponeurosis

  Triangular sheet of dense connective tissue overlying the long flexor tendons in the palm, with longitudinal, transverse, and vertical fibre bundles. The longitudinal fibres condense into the pretendinous bands. The aponeurosis becomes the source tissue for cord formation in Dupuytren's disease.

• Anatomy

  Spiral cord

  Pathological cord formed by the confluence of the pretendinous band, spiral band, lateral digital sheet, and Grayson's ligament. Displaces the digital neurovascular bundle palmarly, centrally toward the digital midline, and proximally — most marked at the level of the proximal phalanx. The principal anatomical reason needle fasciotomy is contraindicated for established proximal interphalangeal contracture.

• Investigation

  Hueston tabletop test

  Functional indication-for-surgery test described by Hueston (The Hand 1982). The patient attempts to lay the palm and fingers flat against a level surface; inability to achieve full flat-palm contact is a positive test. Used as a clinical threshold for considering operative correction, alongside patient-reported impairment.

• Glossary

  Tubiana classification

  Five-stage assessment of Dupuytren's contracture severity by total flexion deformity of an affected ray (sum of MCP, PIP, and DIP extension deficits): stage 0 (no disease), stage N (nodule, no contracture), stage 1 (0–45°), stage 2 (46–90°), stage 3 (91–135°), stage 4 (>135°). Described by Tubiana, Michon, and Thomine in 1968.

• Glossary

  Diathesis

  Constitutional predisposition to a more aggressive disease course and higher recurrence risk. The Hindocha 2006 modification of the original Hueston 1963 diathesis adds male sex and onset before age 50 to the original four features (Northern European descent, bilateral disease, ectopic disease, family history); the cumulative count predicts recurrence.

Articles mentioning this term

1. Patient information · 5 May 2026

   Dupuytren's disease

   A plain-language guide to Dupuytren's disease — what it is, what causes it, how it is diagnosed, and the contemporary treatment options including needle fasciotomy and limited fasciectomy. Written for patients by a consultant hand surgeon.

← Back to glossary