Dupuytren’s Contracture

Dupuytren’s contracture is a thickening and tightening of tissue beneath the skin of the palm, causing fingers to gradually bend into the palm and become difficult to straighten.

Thickened cords or nodules in the palm, progressive inability to fully straighten one or more fingers (usually the ring and little fingers), and difficulty with tasks like placing the hand flat or wearing gloves.

The exact cause is unknown; genetics, Northern European ancestry, smoking, diabetes, and alcohol use are recognized risk factors.

See a hand surgeon when a finger cannot be fully straightened or when the contracture interferes with hand function.

Clinical examination assessing the degree of finger contracture and the "tabletop test," where the hand cannot be placed flat on a surface.

Usually a clinical diagnosis; imaging is not typically required.

Observation is appropriate for mild cases without functional limitation; needle aponeurotomy or collagenase injection can be used for select cord patterns.

Surgery is considered when finger contracture significantly limits hand function, typically once the finger cannot lie flat.

Fasciectomy surgically removes the diseased tissue (cords) to allow the finger to straighten, performed under regional or general anaesthesia.

Hand therapy and splinting are used after surgery to maintain finger extension; full recovery typically takes six to twelve weeks.

Most patients achieve significant improvement in finger straightening, though recurrence can occur over years.

Infection, stiffness, nerve injury, incomplete correction, and recurrence over time.