Abstract

Guillaume Dupuytren 1 was born in Pierre-Buffière, near Limoges on 5 October 1777, the second of nine children, three of whom died in infancy. The family background was a line of barber-surgeons. His schooling years were the years of the French Revolution which he spent as a young student in Paris. He studied basic science leading to surgery with various Paris consultants and at the Ecole de Médecine until 1802 when he was appointed junior surgeon at the Hôtel-Dieu. He was to stay there for over 30 years, becoming its most senior surgeon. He had outstanding talent as operator, teacher, writer and observer, each of which helped him to overcome an unhappy marriage. He was the first to excise the lower jaw, amputate the cervix, establish an artificial anus and classify burns, but his immortality seems to stem from his description of idiopathic contracture of the palmar fascia. He became surgeon to Louis XVIII (1755–1824) and Charles X (1757–1836) of France and in 1821 Louis XVIII conferred on him the hereditary title of Baron Dupuytren. He visited London in 1826 and developed a cordial relationship with Sir Astley Paston Cooper (1768–1841). Dupuytren died on 8 February 1835 due to a combination of empyema and kidney stones with renal colic. He is buried beneath a great stone obelisk and alongside that of his wife Geneviève Eugenie de St Olive (1794–1866) in the Père-Lachaise cemetery in Paris.
Theories abound concerning contracture of the palmar fascia may be seen in victims of alcoholic cirrhosis and diabetes and in persons with epilepsy who receive phenytoin. Irrespective of the initial inflammatory trigger, various growth factor cytokines allow fibroblastic proliferation to collagen deposition and fibrosis.
