Dupuytren’s contracture
Dupuytren’s contracture is when one or more of your fingers bend inwards towards your palm, and you cannot straighten the finger. It is caused by a progressive thickening of the connective tissue of the palm. It is sometimes called “Dupuytren’s disease” as not everyone with this condition goes on to develop contractures. Sometimes, only one hand will be affected, but commonly, Dupuytren’s affects both hands.
Dupuytren’s contracture is not usually painful. The main problem that patients with this condition face is that if contractures develop, it can become difficult to use the affected fingers properly.
In many cases, the condition remains mild and does not require any further treatment and does not interfere too much with the function of the hand.
However, if your symptoms start becoming more severe, or your hand function worsens; for example, with permanently bent fingers ‘getting in the way’ and catching objects, you will be referred to a specialist, who may recommend treatment.
The need for treatment can be reviewed from time to time, so if your condition has changed or worsened, you should arrange to see your GP.
Local commissioning policies are in place for this condition
Please be aware that there are local commissioning policies in place for this condition. This means that certain treatments may not be available to you on the NHS.
Please click here for more information.
Selfcare and more information
Causes and prevention
Dupuytren’s contracture happens when the tissue under the skin near your fingers becomes thicker and less flexible.
The exact cause is unknown, but it’s been linked to:
- having a family history of the condition
- smoking
- drinking lots of alcohol
- having diabetes or epilepsy
It’s not known if you can prevent it or stop it coming back
Non-surgical treatment options
Traditionally, Dupuytren’s contracture is treated with an operation to straighten the finger(s). However, surgery is not always the best or the most appropriate option.
In mild disease, where there is only a limited contracture, or the bent finger(s) are not impacting on use/function of the hand, then no treatment is required.
Splinting, stretching, local steroid and collagenase injections are not recommended.
The need for treatment can be reviewed from time to time, so if your condition has changed or worsened, you should arrange to see your GP.
Surgery to straighten the fingers
Expectations
If you have been referred, speak to your surgeon about the options, what the benefits and risks are, and what to expect afterwards.
It is important to know that your finger may not be completely straight after treatment and might not be as strong and flexible as it used to be.
The contracture could also come back after a few years.
Needle Fasciotomy – using a needle to straighten the fingers
A needle is inserted into several places along your palm and finger to loosen and straighten it.
- Local anaesthetic (your hand is numbed)
- You can leave hospital the same day
- Recovery time: up to 2 weeks
- Contracture more likely to come back than with surgery
- Risks include a cut opening in your skin, pain and numbness
Collagenase Injections
The use of collagenase clostridium histolyticum (Xiapex®) injections to treat Dupuytren’s has been discontinued in the UK following the withdrawal of NICE technology appraisal guidance TA459
Open Fasciectomy
A cut is made along your palm and finger so the surgeon can straighten it.
- General anaesthetic (you’re asleep) or local anaesthetic (your hand is numbed)
- You can leave hospital the same day
- Recovery time: 4 to 12 weeks
- Risks include bleeding, numbness and infection
What to expect after treatment – Recovery and aftercare can vary
You may:
- have a cast or support (splint) on your hand for a few days
- have some pain, stiffness, bruising and swelling for a few weeks
- need to wear a splint while sleeping for 3 to 6 months
- be advised to do hand exercises for up to 6 months – you might see a physiotherapist
You can often start using your hand again after a few days, but it may be a few weeks before you can return to all your activities.
Useful information about Dupuytren’s Contracture
- Click here for more information from The British Society for Surgery of the Hand
- Click here to read more information from the NHS website (formerly known as NHS choices)
- Click here to visit our Health, Lifestyle & Wellbeing page for lifestyle advice
Waiting for a specialist opinion
If you have been referred for a specialist opinion your details will be reviewed and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.
How long will I wait?
If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.