Symptoms and degree of impairment of activities

Age at presentation and duration of the disease

Family history of Dupuytren’s disease

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  Dupuytren’s diathesis: Young age at onset, positive family history, bilateral disease, and ectopic lesions

  
  
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  More prevalent in northern Europeans and Japanese

Sex: More common in males

May have history of plantar fascia (ledderhose disease) or Penile (peyronie disease) involvement

Risk factors: Alcohol, epilepsy medications, diabetes mellitus, and smoking

Previous surgical treatment for this condition

Trauma to the palm can result in traumatic palmar fasciitis

Observe presence and location of pits, modules, and cords

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  Palpate for symptomatic nodules and cords

Note digits and joints involved, and measure the degree of contracture

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  Tabletop test: Patient is unable to lay the palm flat on a rigid surface

  
  
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  Adduction contracture of the thumb

Assess integrity of extensor mechanism

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  Flex wrist and MCP joint to create tenodesis effect

  
  
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  An extensor lag indicates that the central slip is attenuated and postoperative extension splinting may be required; the patient should be cautioned that full extension of the affected finger will likely not be regained

Sensory examination of all digits

Sites of ectopic disease

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  Garrod’s nodes (nodules on dorsum of PIP joint) and knuckle pads (fibrosing lesions on dorsum of PIP joint)

  
  
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  Ledderhose disease (plantar fibromatosis)

  
  
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  Peyronie’s disease (penile fibromatosis)