Dupuytren contracture: A gradual thickening and tightening of the fascia (fibrous tissues layer) under the skin of the palm and fingers in the hand.
1822 – Sir Astley Cooper (1768-1841) reported digital contractures, and deemed them ‘incurable by operation‘
1831 – Dupuytren first to realise that the basic ‘lesion‘ for contracture lay in the palmar fascia rather than the skin or tendons. He operated on the contracture of a French wine merchant (1811) with success, taking a swipe at AP Copper at the same time
1833 – Jean-Gaspard-Blaise Goyrand (1793-1866) presented at l’Academie Royale de Médecine, claiming Dupuytren was in error on three points:
- Dissections showed bands flexing fingers and the thumb, beyond the normally accepted limits of the palmar aponeurosis
- A longitudinal incision allowed better healing and even some fascial excision (possibly the first fasciectomy)
- The condition was more hereditary than occupational in origin
1835 – Goyrand demonstrated that excision of a transverse segment of palmar aponeurosis and direct suture of this defect will produce flexion only at the MP and not at the IP joints. Goyrand proposed that the ‘predigital bands‘ which flexed the fingers, were formed from the ‘fibro-cellular subcutaneous tissue‘ of the fingers. This ‘extrinsic‘ theory of aponeurotic retraction origin directly opposed the ‘intrinsic‘ theory of Dupuytren – a concept supported by the work of Velpeau (who claimed priority…).
- Sir Astley Cooper (1768-1841)
- Baron Guillaume Dupuytren (1777-1835)
- Jean-Gaspard-Blaise Goyrand (1793-1866)
- Alfred-Armand-Louis-Marie Velpeau (1795-1867)
- Dupuytren’s disease
- Palmar fibromatosis
- Dupuytren G. De la rétraction des doigts par suite d’une rétraction de l’aponévrose palmaire. Paris, 1831; 2s; 5: 352-365.
- Dupuytren G. Permanent retraction of the fingers, produced by affection of the palmar fascia. Lancet, London, 1833-1834; 2: 222-225. English translation and reprint in Medical Classics, 1939; 4: 142-150
- Goyrand G. Nouvelles recherches sur la rétraction permanente des doigts. Mémoires de l’Académie royale de médecine, 1833, 3: 489-496. [Critique: Sanson J, Breschet G. 496-500] [Discussion following critique reported in Gazette médicale de Paris, 1834;2s(2):219 with comments by Barthélemey, Cloquet, Dupuy, Lisfranc, Martin-Solon and Velpeau…]
- Goyrand G. De la rétraction permanente des doigts. Gazette médicale de Paris. 1835; 2s(3): 481-486.
- Peltier LF. Guillaume Dupuytren and Dupuytren’s fracture. Surgery. 1958;43(5):868-74.
- Elliot D. The early history of contracture of the palmar fascia. Part 1: The origin of the disease: the curse of the MacCrimmons: the hand of benediction: Cline’s contracture. J Hand Surg Br. 1988; 13(3): 246-253.
- Elliot D. The early history of contracture of the palmar fascia. Part 2: The revolution in Paris: Guillaume Dupuytren: Dupuytren’s disease. J Hand Surg Br. 1988; 13(4): 371-378
- Elliot D. The early history of contracture of the palmar fascia. Part 3: The controversy in Paris and the spread of surgical treatment of the disease throughout Europe. J Hand Surg Br. 1989; 14(1): 25-31.
- Gudmundsson KG, Arngrímsson R, Sigfússon N, Björnsson A, Jónsson T. Epidemiology of Dupuytren’s disease: clinical, serological, and social assessment. The Reykjavik Study. J Clin Epidemiol. 2000; 53(3): 291-296.
- Gudmundsson KG, Jónsson T, Arngrímsson R. Guillaume Dupuytren and finger contractures. Lancet. 2003; 362(9378): 165-168
- Gilgenkrantz S. Le baron Guillaume Dupuytren [The Baron Guillaume Dupuytren]. Med Sci (Paris). 2006; 22(8-9): 771-772. [PDF]
- Battaloglu E, Deshmukh RG. Dupuytren’s contracture: Current understanding of the condition and its management. Hard Tissue 2014;3(1):3
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