Dupuytren contracture

Description

Dupuytren contracture: A gradual thickening and tightening of the fascia (fibrous tissues layer) under the skin of the palm and fingers in the hand.


History

1822Sir Astley Cooper (1768-1841) reported digital contractures, and deemed them ‘incurable by operation

1831Dupuytren 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

1833Jean-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…).


Associated Persons

Alternative names
  • Dupuytren’s disease
  • Palmar fibromatosis

Controversies

Sir Astley Cooper (1768-1841) had previously reported digital contractures, but deemed them “incurable by operation


References

Historical references

Review references


eponymictionary CTA

eponymictionary

the names behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.