Dupuytren's Contracture
What is Dupuytren's Contracture?
Dupuytren's contracture is a condition in which the connective tissue beneath the skin of the palm (fascia) gradually thickens and tightens. Over time this forms firm nodules and cords that progressively draw one or more fingers into a permanently bent position. The ring and little fingers are most commonly affected, though any finger can be involved.
The condition develops slowly over years. Many patients first notice a firm nodule in the palm, often painless, before a cord becomes palpable and the finger begins to pull inwards. In advanced cases the finger cannot be fully straightened, making everyday tasks such as gripping, shaking hands, putting on gloves or washing the face significantly difficult.
Dupuytren's contracture cannot be cured, but the progression can be monitored and the contracture corrected through a range of procedures. Hand Therapy plays a central role both in the initial assessment of severity and in rehabilitation following any intervention.
What causes Dupuytren's Contracture?
- Strong genetic predisposition: common in people of Northern European descent
- Male sex: significantly more prevalent in men
- Increasing age: incidence rises considerably from the fifth decade onwards
- Diabetes: a well-established associated risk factor
- Manual labour and vibration exposure: debated, but recognised as a contributing factor
Signs & symptoms
- A firm, painless nodule in the palm, typically at the base of the ring or little finger
- A palpable cord running from the palm into the finger
- Progressive inability to fully straighten one or more fingers
- Difficulty with flat-hand tasks such as pressing on a surface, typing or wearing gloves
- Pitting or dimpling of the palmar skin overlying the cord
How Hand Therapy can help
Ms Razo provides specialist assessment and evidence-based treatment for Dupuytren's Contracture. Following a thorough initial assessment, a personalised treatment plan will be developed to address your specific needs and goals.
Ms Razo performs a detailed assessment of the degree of contracture. For early-stage disease without significant functional limitations, structured monitoring is appropriate. Ms Razo will advise on when intervention is indicated.
Following needle fasciotomy, open fasciectomy or dermofasciectomy splinting may be indicated. Orthoses maintain the corrected finger position, protect healing tissue and prevent early recurrence. Ms Razo fabricates custom, thermoplastic orthoses fitted precisely to your hand.
A structured rehabilitation programme is prescribed to restore full active and passive finger extension, optimise range of movement and improve hand strength. Rehabilitation begins early to optimise the outcome of any procedure.
Following open fasciectomy or dermofasciectomy, hypertrophic or tight scarring can limit finger extension and cause discomfort. Ms Razo provides specialist scar management including silicone therapy, desensitisation and manual techniques to soften and mobilise scars.
Post-operative swelling is common following Dupuytren’s releases. Ms Razo provides targeted oedema management to reduce swelling, restore circulation and allow early mobilisation.
Frequently asked questions
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No. Many patients with Dupuytren's contracture, particularly those with early nodule formation and no significant flexion contracture, do not require immediate intervention. Monitoring and Hand Therapy assessment are appropriate first steps. Intervention is generally considered when the contracture reaches 30 degrees or more at the affected joint(s), or when function is significantly affected.
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Hand Therapy cannot reverse Dupuytren's disease. If you are experiencing associated pain or sensitivity, specialist Hand Therapy can often improve symptoms getting in the way of your daily routine. Hand Therapy is essential following any corrective procedure. Without post-procedural rehabilitation, the corrected position is less likely to be maintained and recurrence is more likely.
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Recovery following open fasciectomy typically takes several weeks to months. Post-operative Hand Therapy begins within the first week. Full recovery of strength and dexterity can take longer, particularly in severe or recurrent cases.
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Recurrence is possible with all treatment options, including surgery. Regular follow-up and early intervention for recurrence gives the best long-term outcome.
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the first step?
Book a consultation with Ms Razo and receive a thorough assessment, precise diagnosis and a personal treatment plan.