Dupuytren’s Contracture

Dupuytren’s contracture, also known as Dupuytren’s disease, is a common hand condition that causes the fingers to curl inwards towards the hand. This condition thickens a layer of tissue in the hand, known as the palmar fascia. Fascia sits underneath the skin in the palm of the hand and, once thickened, can form into a thick lump or cord of scar tissue. This lump or cord can pull the fingers, causing one or more fingers to curl inwards towards the palm or sideways in a bent position. Once thickened, the fascia tightens over time, which creates tension in the fingers, known as the Dupuytren’s contracture. This condition can worsen over time, affecting hand function and making daily tasks difficult. Any finger can be affected by this condition, however, the ring finger and its accompanying little finger are usually affected. In some rare cases, the feet can be affected by Dupuytren’s contracture.

There is no clear cause for Dupuytren’s contracture, however, genetics can play a key role in the development of this condition. This disease is known to be hereditary and can be more prevalent in men than women. Those with diabetes, epilepsy, smokers and heavy drinkers are at more risk of developing the condition.

Benign nodules are the first symptom of this disease that appears. Then, the scar tissue cords will tighten, pulling your fingers towards your palm. Not everyone with Dupuytren’s disease develops this symptom, and instead the condition can just develop nodules. Dupuytren’s contracture differs per person, with some saying that it is painful and others experiencing no pain. This condition usually restricts the movement of the hands, limiting the daily activity of those affected by it, such as any action that involves bending fingers. Once this condition progresses to this severity, surgical and non-surgical treatments can be used to prevent the disease’s advancement and to aid in levels of movement in the hand.

The Consultation

Dupuytren’s contracture can be diagnosed with a clinical consultation and visual examination.

In your consultation, Dr Laniewski will discuss the suitable treatment for your individual case. X-rays and scans are not necessary for examination and will only be utilised in severe cases.

Dupuytren’s Contracture Treatments

Dr Laniewski will curate a care plan, based on your age, medical and family history, and the development of your case. Unfortunately, this condition cannot be cured, but it can be treated, and the disease can be slowed down. There are several options for treatment, with the most common being a surgical procedure called fasciectomy. For cases that have advanced, surgery may be highly recommended to assist hand movement and is performed under local, regional or general anaesthesia. This procedure begins with a small incision in the hand, and then the fascia is removed to improve the flexibility of the hand. Despite surgery, contractures can return and multiple surgeries are sometimes needed to completely remove the tissue. In extreme cases, a skin graft may be needed however, Dr Laniewski will discuss the procedure with you in depth before it is performed. Steroid shots are sometimes needed to ease painful nodules and lessen symptoms of the contracture. Several steroid shots are sometimes needed to fully take effect.

Fasciotomy Recovery

The recovery process after a fasciotomy will differ per case based on the severity of the contracture and whether a skin graft was required. Dr Laniewski will adjust your care plan to cater to your personal needs. Severe complications are not common after surgery, however swelling, pain and stiffness are common side effects of fasciotomy. To decrease swelling and stiffness, patients are recommended to elevate their hand and move their fingers post-surgery. Often, a hand is dressed in a splint after your surgery to help guide the recovery process. Hand therapy may be recommended to support the hand’s mobility. It is recommended that patients who have recently had a fasciotomy not return to work until fully healed, however around the two to three week mark after surgery, you may be able to return to work on light duties. Those with manual jobs are recommended to wait longer as heavy lifting and strenuous movements will still need to be avoided.

Who is Eligible for Surgery?

Anyone diagnosed with Dupuytren’s contracture may be eligible for treatment, with surgery as a potential option for those with limited hand mobility, and advanced disease. Those whose symptoms are worsening may be recommended to have a fasciectomy to improve their hand movement. However, your eligibility for surgery will need to be determined during a consultation, as individual health factors will need to be considered.

Are There Risks to Dupuytren’s Contracture Surgery?

Every surgery has a risk of complications. A fasciectomy for a Dupuytren’s contracture has a few risks that could occur after the surgery. If you have other medical conditions, multiple contractures and an advanced case, these can all increase the risk of complications. The complications associated with a fasciectomy are recurrence, pain post-surgery, scarring, injury to nerves or blood vessels, infection, stiffness and loss of sensation. In rare cases, loss of movement in a finger can occur, however, measures will be taken to avoid this outcome. Dr Laniewski will discuss the procedure in detail to ensure you understand the risks associated with the surgery.


Does age play a factor in developing Dupuytrens Contracture?

Age may play an important role in the risk of developing Dupuytren’s contracture, as it commonly occurs in those over the age of 50.

What medical conditions increase the chances of developing Dupuytren’s contracture?

Those with diabetes, liver disease, tuberculosis, high cholesterol and thyroid problems may be more likely to develop Dupuytren’s contracture. If you have previously injured your hand, this can also affect the risk factor.

Can Dupuytren’s contracture heal without treatment?

Unfortunately, Dupuytren’s contracture will not heal over time without treatment, and is more likely to progress over time. Treatment or surgery may be recommended for suitable candidates to stop this progression.