Dupuytren’s Contracture: When to Consider Treatment
Dupuytren’s contracture is a condition affecting the hand where the tissue beneath the skin of the palm thickens and tightens. Over time, this can form cords that pull one or more fingers—most commonly the ring and little finger—into a bent position. It is usually not painful but can interfere with everyday function.
Early Stages
Early Dupuytren’s may present as small lumps or thickening in the palm without finger contracture. At this stage, treatment is not typically recommended. Gentle stretching can help maintain mobility, although it does not reverse the condition.
When is Treatment Needed?
Surgery is considered when finger position begins to limit function.
Typically when the bend is:
Around 30 degrees at the knuckle (MCP joint)
Any significant bend at the middle joint (PIP joint)
If you are unable to place your hand flat on a table, this is often a practical sign that treatment should be discussed.
It is also important not to wait under the disease is severe for treatment as it increases the difficulty of the surgery.
Surgery removes the tight cord and allows the finger to straighten again. It doesn't cure the disease, so there are some people who develop Dupuytren's contracture again many years after treatment.
Surgery and Recovery
Surgery is typically performed as a day case procedure, removing the tight cords to allow the finger to straighten.
10 days: Bulky dressing in place
Day 10: Stitches removed
3 weeks: Movement improving and can restart most activities (including golf).
6–12 weeks: Total duration of recovery
Hand therapy may be recommended to support recovery.
Risks
Potential risks include:
Slow skin healing
Temporary pain and stiffness
Nerve injury causing numbness on one side of the finger (temporary or permanent)
Summary
Dupuytren’s contracture is a progressive condition. Early management focuses on maintaining movement, while surgery is effective once function becomes limited. Timely treatment helps optimise outcomes and recovery.