The Pathogenesis of Dupuytren’s Contracture EXPERIMENTAL AND FURTH I’It CLINI’AL O1ISERVATBINS*

In 1833 Dupuytren first described the contracture of the hand that has since borne his name. He believed the affliction to be caused by repeated trauma to the palm. From that time on a great- deal was written concerning this disease and the idea that trauma is an etiological factor was either supported or con-demned repeatedly. In 1948 Skoog published an extensive monograph on Dupuytren’s contrac-tare. In this monumental work he incorporated a comprehensive description of the pathological changes in this disease, including the nodular hypercellular areas within the aponeurosis. He believed these cellular nodules to he the early stages of the disease. At the margins of these lesions he noted microscopic ruptures of the collagen fibers of the palmar fascia and hemosiderin deposits within the cellular areas. These, he believed, were evidence of previous small hemorrhages. Skoog concluded that- Dupuytren’s contracture began when microscopic ruptures of the collagen fibers of the fascia occurred. In 1958 we (Larsen and Posch) reported our interpretation of the abnorma