Dupuytren’s Contracture
- Rikki Mistry
- Sep 10
- 4 min read
Updated: Oct 8
If lumps, thick bands, or fingers being pulled toward your palm are making it harder to use your hand, you may have Dupuytren’s Contracture. This condition can gradually limit simple tasks like gripping, typing, or placing your hand flat on a table.
Mr Rikki Mistry, a highly regarded Consultant Plastic Surgeon specialising in hand surgery, offers expert, empathetic care to help restore comfort and confidence in your hand function.
Understanding Dupuytren’s Contracture
Dupuytren’s Contracture is a condition where the connective tissue (known as fascia) beneath the skin of the palm thickens and tightens, forming lumps (nodules) and cords that pull one or more fingers - often the ring or little finger - toward the palm.
This process can be painless for many, though some experience itching or mild discomfort. It typically affects adults over 40 and is more common in men, particularly those of Northern European descent. Genetics play a major role, and risk is elevated by factors such as diabetes, smoking, alcohol use, and certain medical conditions.
Diagnosis is made through physical examination alone - no special tests are usually required.
What is Dupuytren’s Contracture?
Dupuytren’s Contracture is a hand condition where the tissue beneath the skin of the palm thickens and forms cords, causing one or more fingers - usually the ring or little finger - to gradually bend toward the palm. Over time, this can make it difficult to place your hand flat or perform everyday tasks like gripping, writing or typing.
How is Dupuytren’s Contracture treated?
Treatment depends on severity. Mild cases may need only monitoring, while more advanced
stages can be treated with minimally invasive needle release while more extensive disease
requires surgery to release or remove the tight cords. Recovery often involves hand therapy,
splinting and exercises to restore movement and reduce the risk of recurrence.
Who can help?
Mr Rikki Mistry, Consultant Plastic Surgeon specialising in hand and wrist surgery, offers expert diagnosis, personalised treatment plans, and advanced surgical care to restore function and confidence in your hands.
Tailored Care for Every Patient
For mild cases not interfering with hand function, a “wait and see” approach may be advised. Regular review helps monitor progression.
Minimally Invasive Techniques
• Needle aponeurotomy (Needle fasciotomy):
A minimally invasive outpatient procedure in which a needle weakens or breaks the cord, allowing the finger to straighten. Quick recovery, but recurrence is common, especially in younger patients and when certain joints are involved.
• Collagenase injections:
An enzyme (collagenase) is injected into the cord, followed by controlled finger manipulation to rupture it. Effective in many cases, though the medication is no longer available in some regions like the UK since around 2020.
• Steroid injections:
May temporarily relieve nodular pain but don’t address the underlying progression. Possible side effects include skin changes or relapse.
• Radiation therapy:
Occasionally used in very early stages to slow disease progression, though evidence is limited and usage is highly selective, especially in the UK.
The Dupuytren’s Contracture Procedures
When hand function is significantly affected (e.g. you can’t flatten your hand on a surface, or joints are locked) surgical intervention may be recommended.
Selective Fasciectomy (partial palmar fasciectomy):
The abnormal fascia is surgically removed, often through zig-zag incisions to minimise scar contracture. Effective in restoring motion but carries risks such as nerve or blood vessel injury, infection or stiffness.
Fasciectomy
The abnormal fascia in the palm and the finger is surgically removed. Although this is a more
complex and extensive operation, the recurrence rates are lower than needle fasciotomy and
selective fasciectomy. Depending upon the extent and complexity of the disease Mr Mistry
conducts these under general anaesthetic, regional block (arm asleep) or local anaesthetic
(WALANT - wide awake local anaesthetic no torniquet).
Dermofasciectomy:
This more extensive surgery removes both diseased tissue and overlying skin, then places a skin graft. It’s used for severe or recurrent cases and offers lower recurrence rates, though recovery is longer.
Amputation
Unusual but may be preferred in a finger with a very severe contracture, after multiple
recurrences and where there has been previous nerve and vessel damage.
Less invasive methods like percutaneous aponeurotomy with lipografting are being explored but are not yet widespread.
Recovery and Aftercare
After any treatment - especially surgery - hand therapy is essential to restore movement and
prevent stiffness. Using modern surgical techniques patients with mild disease can return to
driving and administrative jobs in 1-2 weeks, whilst more extensive disease or more physical
jobs may require longer to recover.
For minimally invasive non-surgical treatment like needling, you’ll likely be advised to
perform regular stretching exercises and, in some cases, use a night splint for several months to maintain results.
Why Choose Rikki Mistry
Specialist Expertise: Mr Mistry is a Consultant Plastic Surgeon with focused experience in hand anatomy, surgery, and complex procedures tailored to delicate structures. With over 15
years of experience, you’ll be in expert hands.
Comprehensive Care: From non-surgical options to advanced surgical techniques like fasciectomy and dermofasciectomy, he offers the full spectrum of treatment, tailored to your stage of disease and lifestyle needs.
Patient-Centered Approach: You’ll receive a clear explanation of treatment choices, potential benefits, and risks, along with dedicated guidance through recovery and long-term care, so you're empowered to make the right decision for your hand health.
