Dupuytren's contracture (Dupuytren's disease) is when the tissue near your fingers becomes thick and less flexible, causing one or more fingers to bend towards your palm.
Nodules and long cords form beneath the skin in your hand. These are hard and inflexible, similar to scar tissue, so you can’t straighten one or more fingers. It usually affects the ring and little fingers and can affect both hands at the same time.
Eventually, your fingers bend towards the palm of your hand — this is called a contracture and can limit what you can do at home and work. Not everyone with this condition will develop contractures, which is why it is sometimes called Dupuytren’s disease.
Dupuytren's contracture is a common condition affecting around one in 20 people in the UK. It’s six times more common in men than women and more common in older people.
There is no cure but it can be treated.
Your doctor may offer you an injection to weaken the tissue that's keeping your fingers bent, or they can be surgically straightened.
Left untreated it tends to get worse over months or years, but only a small number of people need surgery.
Contractures (bending of the fingers towards the palm) can vary in severity and usually affect both hands.
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If your fingers are bent and you can't lay your hand down flat or find daily tasks using your hands difficult, you should see your GP.
Your GP should be able to give you an accurate diagnosis after asking you some questions and a careful examination of both hands.
No other tests or investigations are likely to be necessary. Your GP will consider other possible causes of your problem, such as a callus, ganglion or trigger finger.
The exact cause of Dupuytren's contracture is still unknown, but it's been linked to:
However, most people with Dupuytren's contracture do not have any of these risk factors. It is not yet known whether this condition can be prevented or stopped from returning.
In the early stages of the disease, treatment usually can’t help. If you're treated, you'll often need treatment again sometime later. Treatment is therefore usually only recommended if your fingers have started bending towards your palm and/or your hand function is affected.
For most people, the condition does not progress to affecting hand function or causing considerable bending of the fingers towards the palm. Dupuytren's contracture may improve without treatment but in most cases, it worsens without treatment. Your doctor can monitor your condition to review whether you need treatment.
Traditional treatment is surgery but there are newer treatments for less severe cases, such as injections and radiotherapy. Surgery is usually only recommended if:
The main treatment options are:
A needle fasciotomy may not be suitable if:
A needle fasciotomy is more often recommended to older people who aren't suitable for more extensive surgery.
As with all surgery, there are risks and possible complications, such as your finger being less flexible, not fully straight or weaker after surgery. Your consultant will carefully explain these. Your contracture may also return a few years after treatment.
Depending on your treatment, your aftercare and recovery will vary. You may need to wear a cast or splint on your hand for a few days and wear a splint when sleeping for 3–6 months. You may also have bruising, pain, stiffness and swelling for a few weeks. Your doctor may recommend doing hand exercises for up to six months and/or may refer you to a physiotherapist.
In most cases, you can start using your hand after a few days but it may be several weeks before you can resume all of your usual activities.
Can Dupuytren's contracture be cured?
No, it can’t be cured but there are several treatments that will resolve symptoms of the condition for several years or more. Treatments include injections, radiotherapy and surgery. However, for most people, Dupuytren’s contracture is mild and does not need any treatment.
Is Dupuytren's contracture painful?
In the early stages of the disease, you may experience pain due to a lump or nodule on the palm of your hand(s). As the condition progresses, hard cords develop in your palms that pull your fingers towards your palm — this is usually not painful although it can cause difficulty using your hand.
Is Dupuytren's contracture an autoimmune disease?
Dupuytren's contracture is not an autoimmune disease. The exact cause of the condition is unknown but is linked to:
However, most people with Dupuytren's contracture do not have any of these risk factors.
How do you slow down Dupuytren's contracture?
In the early stages of Dupuytren's contracture, radiotherapy can slow down the progression of the condition. This involves exposing your affected hand to several low doses of radiation.
What aggravates Dupuytren's contracture?
Several lifestyle factors are risk factors for Dupuytren’s contracture and may aggravate the condition. These include drinking too much alcohol, smoking and using vibrating hand tools.
Does Dupuytren's affect other parts of the body?
Yes, Dupuytren’s disease can cause thickening of the tissue under your skin in other parts of your body, such as your knuckles or soles of your feet, and in men, the penis.