Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 41-04: Upper Extremity Musculoskeletal Injuries + Key Features Download Section PDF Listen +++ ++ Benign fibrosing disorder of the palmar fascia Contracture of one or more fingers can lead to limited hand function Cause is unknown Occurs primarily in white men older than 50 years. The incidence is higher among alcoholics and patients with chronic systemic disorders (especially cirrhosis) Also associated with systemic fibrosing syndrome, which includes Plantar fibromatosis (10% of patients) Peyronie disease (1–2%) Mediastinal and retroperitoneal fibrosis Riedel struma + Clinical Findings Download Section PDF Listen +++ ++ Onset may be acute, but slowly progressive chronic disease is more common Nodular or cord-like thickening of one or both hands, with the fourth and fifth fingers most commonly affected Tightness of the involved digits, with inability to satisfactorily extend the fingers; on occasion, there is tenderness The contracture is well tolerated because it exaggerates the normal position of function of the hand, although resulting cosmetic problems may be unappealing + Diagnosis Download Section PDF Listen +++ ++ Clinical findings outlined above + Treatment Download Section PDF Listen +++ ++ Corticosteroid injection with a percutaneous needle aponeurotomy has shown some promise If the palmar nodule is growing rapidly, injections of triamcinolone or collagenase into the nodule may be of benefit Surgical options include open fasciectomy, partial fasciectomy, or percutaneous needle aponeurotomy and are indicated in patients with significant flexion contractures Splinting post surgery is beneficial Compared to placebo, tamoxifen therapy produced moderate evidence of improvement before or after a fasciectomy