Dupuytren's contracture--etiology and principles of treatment.

Although Dupuytren's contracture was first described more than 300 years ago, the cause is not yet certainly known. It is only agreed that the disease process affecting the palmar fascia is most commonly found in older-aged males of Caucasian descent. Conservative or non-surgical treatment is usually ineffective. Surgical treatment includes fasciotomy, partial fasciectomy and total fasciectomy. Fasciotomy is indicated for localized disease or for patients with medical conditions which preclude more extensive operation. Subtotal fasciectomy with or without skin graft is the most commonly employed procedure. Total palmar fasciectomy is seldom indicated. Improved function of the hand can be anticipated after adequate surgical intervention.