Hyperplasia of the Palmar Aponeurosis (Dupuytren's Contracture)

Introduction  Numerous attempts have been made to determine the cause of Dupuytren's contracture. The results can be classified as follows.

(1) Trauma.  —Dupuytren, himself,²⁴ considered repetitive trauma of the handpalm to be the cause of the contracture. An investigation conducted on behalf of the British government among lace minders showed an incidence of 13.1% Dupuytren's contracture.¹⁸ Three years later a similar inquiry found the rate to be only 1.7%, the discrepancy being attributed to the lower average age in the second group.¹⁰ This opinion was supported by Gerritzen.³⁰ About 20 years later another investigation was unable to demonstrate that trauma was of any etiologic significance.³⁶ Niederland found four times as high an incidence in people whose hands underwent repetitive trauma in the course of their occupation as in those with less traumatizing work. When presenting this series he was supported by Baader, but also met