Dupuytren Contracture

It can take a long time for Dupuytren contracture to develop, so you might not notice any symptoms at first. 

When you do, the signs tend to appear in a specific order:

1. Nodules – small bumps form on your fascia under the skin of your palm, usually found where your fingers meet your palm. You might be able to feel or see them – in some people, they can make the skin around them look dimpled or puckered.

2. Cords – as time passes, these nodules can thicken into long cords of tissue on your fascia, pulling your fingers towards your palm.

3. Contracture – the cords grow tighter and thicker, so you can’t straighten your fingers, or lie your hand palm down on a flat surface. This stage tends to happen slowly over time.

While not as common, other symptoms can include:

• inflammation or swelling

• tenderness

• pain or burning

• itching

Dupuytren contracture happens when the connective tissue under the skin of your palm becomes thicker and less flexible. The cause of this isn’t fully understood, but you may be more likely to develop it if you:

• are male

• are in middle or late age

• are of Northern European descent

• have a family history of the condition

• have had trauma to the hand (such as a fracture) or surgery

A doctor or specialist can usually diagnose Dupuytren contracture by examining your hands and fingers. They’ll check for puckering, see if you can flatten your hand (palm down) on a table with the ‘Table Top’ test, and press on parts of your hands and fingers to check for hard knots.

As it’s a genetic condition, there’s no way to avoid developing Dupuytren contracture.

If you have severe Dupuytren contracture and don’t get it treated, your fingers might get stuck in a bent position permanently, meaning you can't use your hand for daily tasks like writing, typing, and shaking hands.

As with all procedures, surgical treatment to improve these symptoms can cause complications in some people, such as:

• nerve damage

• infection

• scarring

• damage to your blood vessels

• wound healing problems

There’s no cure for Dupuytren contracture, but symptoms can be well managed with treatment. 

The type of treatment offered can vary depending on how severe your condition is. If your symptoms are mild and progressing slowly, you might not need treatment at all, or less invasive methods only, such as: 

• physical therapy or stretching exercises

• bracing or splinting for support

• heat treatments to increase flexibility

• steroid injections to shrink nodules and cords

If your condition is severe or other methods haven’t helped, treatment involves removing or breaking the cords that are forcing your fingers to bend. These methods include:

• needle fasciotomy – a needle is inserted beneath the skin and the cord in the hand. The fibres of the cord are divided to allow the affected finger(s) to straighten again

• chemical fasciotomy – a chemical is injected beneath the skin and the cord in the hand, which dissolves collagen and allows the affected finger(s) to straighten again

• segmental fasciectomy – when short sections of cord in the hand are removed to allow for bending and straightening of the fingers

• regional fasciectomy – the whole cord in the hand is removed, allowing for full movement of the fingers. This is a more invasive operation, which involves removing abnormal tissue

• dermofasciectomy – all diseased tissue is removed, as well as any overlying skin. It’s used for people with repeated and severe Dupuytren contracture

While surgery can help improve your quality of life, some people still aren’t able to straighten their fingers completely afterwards, or find their affected hand isn’t as strong and flexible as it was before. 

Depending on the chosen treatment option, there’s also a chance that the contracture could come back over time.

At Welbeck, our orthopaedic consultants are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.