Dupuytrens contracture (also called Dupuytrens disease, Morbus Dupuytren, Viking disease, palmar fibromatosis and Celtic hand) is a condition in which one or more fingers become progressively bent in a flexed position. It is named after Guillaume Dupuytren, who first described the underlying mechanism of action, followed by the first successful operation in 1831 and publication of the results in The Lancet in 1834. It usually begins as small, hard nodules just under the skin of the palm, then worsens over time until the fingers can no longer be fully straightened. While typically not painful, some aching or itching may be present. The ring finger followed by the little and middle fingers are most commonly affected. It can affect one or both hands. The condition can interfere with activities such as preparing food, writing, putting your hand in a tight pocket, putting on gloves, or shaking hands.The cause is unknown but might have a genetic component. Risk factors include family history, alcoholism, smoking, thyroid problems, liver disease, diabetes, previous hand trauma, and epilepsy. The underlying mechanism involves the formation of abnormal connective tissue within the palmar fascia. Diagnosis is usually based on a physical exam. Blood tests or imaging studies are not usually necessary.Initial treatment is typically with a cortisone shot into the affected area, occupational therapy, and physical therapy. Among those who worsen, clostridial collagenase injections or surgery may be tried. While radiation therapy is used to treat this condition, the evidence for this use is scarce.
Manual workers
Alcoholics

Other conditions
People with a higher-than-average fasting blood glucose level
People with previous hand injury
People with Ledderhose disease (plantar fibromatosis)
People with epilepsy (possibly due to anti-convulsive medication)
People with diabetes mellitus
People with HIV
Previous myocardial infarctionIn one study, those with stage 2 of the disease were found to have a slightly increased risk of mortality, especially from cancer. Diagnosis
Types
According to the American Dupuytrens specialist Dr. Charles Eaton, there may be three types of Dupuytrens disease:
Type 1: A very aggressive form of the disease found in only 3% of people with Dupuytrens, which can affect men under 50 with a family history of Dupuytrens. It is often associated with other symptoms such as knuckle pads and Ledderhose disease. This type is sometimes known as Dupuytrens diathesis. Type 2: The more normal type of Dupuytrens disease, usually found in the palm only, and which generally begins above the age of 50. According to Eaton, this type may be made more severe by other factors such as diabetes or heavy manual labor. Type 3: A mild form of Dupuytrens which is common among diabetics or which may also be caused by certain medications, such as the anti-convulsants taken by people with epilepsy. This type does not lead to full contracture of the fingers, and is probably not inherited. Treatment
Treatment is indicated when the so-called table-top test is positive. With this test, the person places their hand on a table. If the hand lies completely flat on the table, the test is considered negative.