What is Dupuytren’s disease?
Dupuytren’s disease is a condition in which the fibrous tissue layer beneath the skin of the palm (the palmar fascia) thickens and shortens. Firm nodules and cords form in the palm and, over time, can pull the fingers into a bent position — a Dupuytren’s contracture. The ring and little fingers are most commonly affected.
The condition often runs in families and is more common in men and with increasing age. It is not caused by manual work, and the nodules themselves are benign.
When is treatment needed?
Many people with Dupuytren’s disease never need treatment. Painless nodules without contracture can simply be observed. Treatment is considered when:
- You can no longer place your hand flat on a table (a useful self-test)
- Finger contracture interferes with washing, gloves, pockets or grip
- The contracture is progressing
Treatment options
- Needle fasciotomy (needle aponeurotomy): the cord is divided through the skin with a needle. A minimally invasive option for suitable cords, with a shorter recovery but a higher recurrence rate.
- Limited fasciectomy: the diseased tissue is removed through an incision in the palm and finger. This is the most established treatment for significant contracture and offers the most durable correction.
- Skin grafting may be added in recurrent or severe disease.
Dr Melsom will discuss which option suits the pattern and severity of your disease.
Recovery
After fasciectomy, the hand is initially bandaged and then managed with hand therapy and night splinting to maintain correction while the tissues heal. Most patients regain good hand function over 4–8 weeks. Dupuytren’s disease can recur over the years, and this is taken into account when planning treatment.