Dupuytren’s Contracture vs Trigger Finger – The Difference

What are Dupuytren’s Contracture and Trigger Finger?

Dupuytren’s contracture and trigger finger are two major deforming hand conditions that look quite similar and can significantly limit hand function.

But what exactly is the difference between Dupuytren’s contracture and trigger finger?

Dupuytren’s Contracture

Dupuytren’s contracture is a slow thickening and tightening of the tissue (fascia) under the skin of the palm. As a result, small cords and knots grow in the palm and joints of the fingers, causing them to bend inward toward the palm. 

Patients usually feel like their hand is “stuck” in that contracted position. This is called a contracture.

This condition primarily affects the ring and pinky finger, making it difficult to perform everyday tasks like shaking hands or gripping objects. It is most common in people of old age, especially men aged 40-70.

Dupuytren’s contracture can often run in families.  It can often be seen in patients with diabetes, metabolic disease, smoking, and alcohol use. Even though these conditions have been reported often in patients with Dupuytren’s, scientists have not figured out exactly why this is, or if there is truly a cause-and-effect relationship.

Trigger Finger

In contrast, trigger finger, also known as stenosing tenosynovitis (inflammation of the lining of joints and tendons that causes narrowing), occurs when the tendons in the finger or the synovial sheath (protective covering) around it become inflamed and swollen. This makes it difficult for the finger to move smoothly. Patients usually feel like their finger(s) “catch” or feel stiff.

As the condition worsens, the finger may suddenly snap straight, like releasing a trigger, or get stuck in a bent position. Women are 6 times more likely to be affected by this injury than men.

This article will explain Dupuytren’s contracture vs trigger finger in detail with their respective symptoms, causes, and treatment. It will give you a better idea of how to tell these two hand conditions apart and what to do if you ever face them.

How Do I Tell Dupuytren’s Contracture and Trigger Finger Apart?

While Dupuytren’s and trigger fingers look similar in most aspects, there is a huge difference between them. See the table below to get a better idea of each.

	Dupuytren’s contracture	trigger finger
Type of condition	Often hereditary condition (familial/genetic)	Inflammatory condition
Pain	Not Painful	Painful
Affected tissue	Involves fascia of the palm and finger(s)	Involves the tendons of the finger(s)
Movement	Cannot straighten finger(s) even with assistance	Can straighten finger(s) with assistance
Population	Usually common in people of older age, especially men	Can affect any age, especially women
Typical sites	Often affects the ring and little finger	Often affects the thumb and pinky finger

While these conditions can be frustrating, effective treatments are available. If you’re having symptoms of either Dupuytren’s contracture or trigger finger, it is important to consult with a hand surgeon. Doctors like Dr. Pamela Mehta give you an accurate diagnosis and suggest the right treatment plan.

Comparing Risk Factors

The exact cause of Dupuytren’s contracture isn’t completely known, but it’s thought to be linked to a person’s genetics. It often runs in families, especially among people of Northern European descent, which suggests it might be hereditary. 

Due to an unknown genetic mutation, the accumulation of collagen occurs in the fascia in the palm. This results in the formation of cords and nodules in the palm that tighten the fascia and cause the symptoms of Dupuytren’s contracture.

Other risk factors include:

• Age above 40
• Lifestyle habits like smoking and drinking alcohol.
• Diabetes
• Epilepsy
• Liver disease
• Metabolic disease

On the other hand, trigger finger is caused by inflammation of the tendon sheath in the affected finger. This inflammation can lead to a narrowing of the sheath, making it difficult for the tendon to glide smoothly during finger movement. 

Some major causes of trigger finger is:

• Rheumatoid arthritis
• Repetitive hand movements or forceful gripping
• Work or hobbies involving significant hand use or trauma/injury to the hand
• Diabetes
• Gout
• Hypothyroidism

Comparing Symptoms

When it comes to trigger finger vs Dupuytren’s contracture, you may look for the following symptoms.

Trigger Finger

• Hand pain or tenderness at the base of the affected finger or thumb.
• A popping, snapping, or clicking sensation when moving the finger.
• A finger may lock in a bent position and suddenly straighten, like a trigger being released.
• Stiffness in the affected area.
• Swelling or a small lump at the base of the finger where the tendon is inflamed.

Dupuytren’s Contracture 

• Gradual thickening and tightening of the skin on the palm.
• Formation of lumps or nodules under the skin of the palm.
• Fingers, usually the ring and little fingers, slowly bend inward toward the palm.
• Difficulty straightening the affected fingers.
• Often painless, but can lead to significant hand function limitations.

Diagnosing Trigger Finger vs Dupuytren’s Contracture

Dupuytren’s contracture diagnosis usually starts with a physical examination of the hand. The doctor looks for thickened skin or lumps on the palm and checks if the fingers can straighten fully. 

A common test is the “tabletop test,” where the patient tries to lay their hand flat on a table. If the hand can’t flatten, even with help from the other hand, because of bent fingers, it’s likely Dupuytren’s contracture. Imaging tests are rarely needed unless another condition is suspected.

Similarly, a trigger finger is also diagnosed through a physical examination of the hand. The doctor will ask about symptoms and observe the finger as it moves, feeling for any popping or catching sensations. Imaging tests like ultrasound and X-ray might be used in some cases to examine the tendon and its sheath, but this is typically not required.

Trigger Finger vs Dupuytren’s Contracture Treatment

Dupuytren’s contracture cannot be treated through conservative methods. The condition is progressive, meaning it usually continues to get worse with time. If the condition gets worse and the fingers bend more, hand surgery is often needed. The surgery is carried out under general anesthesia in an outpatient setting and involves the following procedures.

1. Fasciectomy (removing the thickened tissue) 
2. Needle aponeurotomy (using a needle to break the tissue cords). 

Another option is to inject a drug called collagenase to break down the tough tissue, followed by straightening the fingers through manual assistance. After the surgery, patients have to wear a splint for at least a week. In some instances, hand physical therapy is also recommended to regain better finger motion.

Trigger finger treatment starts with non-invasive methods if you feel mild discomfort in your hand. These include:

• Resting the affected finger
• Using a splint
• Avoiding activities that strain the hand

If symptoms persist and you experience serious discomfort, you can consider the following measures.

• Over-the-counter pain relievers
• Anti-inflammatory medications
• Corticosteroid injections

These can help reduce inflammation and pain. In more severe cases where the finger remains locked or other treatments fail, surgery may be required. The surgical procedure involves releasing the tendon sheath to allow smoother movement. This leads to quick recovery and restored finger function.

Let’s see the table below for a more comprehensive view of both conditions.

Feature	Dupuytren’s Contracture	Trigger Finger
Cause	Genetic conditions, injury, diabetes, smoking, alcohol consumption, liver disease, metabolic disease.	Repetitive motion, inflammation, injury, diabetes.
Symptoms	Gradual curling of fingers.	Locking sensation, often with a popping or clicking sound.
Diagnosis	Physical examination	Physical examination, ultrasound, X-ray.
Lifestyle Impact	Difficulty with daily activities, occasional pain, limited hand function.	Pain, reduced grip strength, difficulty with fine motor skills.
Treatment	Steroid injections, surgery (fasciotomy or lumpectomy), needle aponeurotomy.	Steroid injections, medications, splinting, surgery.

Understanding the differences between both conditions can help you spot the early signs better. Still, it’s better to seek professional help when symptoms worsen or become difficult to manage.

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