Dupuytren's Contracture

What is Dupuytren's Contracture?

Dupuytren’s contracture is a condition where thickened tissue under the skin of the palm causes fingers (usually ring or little finger) to curl toward the palm. It’s often painless but restricts hand function.

When Should I Seek Treatment?

You should consider treatment if:

When the finger cannot be laid flat on a table

When it begins to interfere with grip or function

What is the NHS Criteria for this procedure?

Dupuytren’s Contracture *For this procedure you should complete a prior approvals request, and once this is granted you should use the acceptance letter and send it with the referral for surgery*

The ICB will only fund intervention (needle fasciotomy, fasciectomy and dermo- fasciectomy) where the following criteria are met:

Finger contractures causing loss of finger extension of 30° or more at the metacarpophalangeal joint or 20° at the proximal interphalangeal joint with significant interference with function

OR
Severe thumb contractures with significant interference with function

Can It Be Treated Without Surgery?

Non-surgical options include:

Physical therapy and stretching exercises combined with massage therapy.

Corticosteroid injection - can help reduce inflammation and alleviate pain.

Surgery is preferred for moderate to severe cases.

What is the Surgery?

A fasciectomy is performed under local anaesthetic and the abnormal thickened is removed allowing finger extension.

What to Expect Before and After Surgery

Before Surgery:

You will have a consultation appointment with the Surgeon to discuss the risks, benefits and recovery. If you are taking any blood thinning medication, it is important that you inform the Surgeon during your consultation. A subsequent appointment will then be for the procedure.

On the day of the procedure, you can eat and drink as normal.

On the day of the procedure, please remove any rings or jewellery from the hand having the operation and to reduce the risk of infection, remove nail polish from both hands.

After Surgery:

Your hand will be bandaged and you will be given instruction on wound care. Keep the heavier bandage on and you hand elevated as much as possible for the first 72 hours.

Mild pain, stiffness and swelling are common but should improve over time. Over the counter painkillers such as paracetamol and ibuprofen are recommended for the first 24 - 48 hours.

Hand therapy exercises will be recommended.

Most patients return to normal activities with a few weeks but full recovery can take longer.

What Are the Risks?

Infection and scarring.

Stiffness, numbness or altered sensation of the fingers.

Incomplete correction or a return of the Dupuytrens Constracture.

How Do I Prepare?

Patients Asking a doctor Questions _edit

Frequently Asked Questions

Q: Can it come back?
A: Yes, particularly in younger patients.