Which tissue is affected by Dupuytren's contracture?

• A. Palmar aponeurosis
• B. Dorsal fascia
• C. Palmar fascia
• D. Flexor tendons

Answer: (C)

Dupuytren's contracture is a fibromatosis of the palmar fascia. In the palm, this tissue forms the palmar aponeurosis, and in this condition it thickens and forms nodules and cords. As these cords contract, they shorten and progressively pull the fingers (usually the ring and little fingers) into flexion at the metacarpophalangeal and sometimes the proximal interphalangeal joints. The primary change is in the palmar fascia, not the dorsal fascia or the flexor tendons themselves; the tendons may become affected secondarily by restricted movement, but the disease process originates in the palmar fascia.