Dupuytren's Contracture Treatment Overview

Dupuytren’s contracture is a progressive hand condition where thickened tissue forms in the palm, eventually pulling one or more fingers toward the palm and limiting hand function. Most commonly affecting the ring and little fingers, this condition can significantly impact daily activities if left untreated. In 2025, a variety of minimally invasive and surgical options allow for targeted, effective management based on contracture severity and patient needs.

What Is Dupuytren’s Contracture?

Dupuytren’s contracture is characterized by:

• Formation of hard nodules or cords beneath the skin of the palm

• Gradual flexion (bending) of affected fingers

• Progression over months or years, sometimes stabilizing with little impairment, but often causing functional problems if it advances

Causes and Risk Factors

Dupuytren’s contracture is more common in individuals over 50, men, those of Northern European descent, and people with a family history of the condition. Risk factors include diabetes, epilepsy, alcoholism, and certain lifestyle or occupational demands that put repeated strain on the hands.

Symptoms and Diagnosis

• Early symptoms: Firm lumps in the palm, puckering of the skin, and gradual tightening of tendons.

• Advanced stage: Cords of tissue pull the affected fingers (commonly the ring and pinky) towards the palm, making it difficult to lay the hand flat.

• Diagnosis is clinical, based on the appearance and feel of the hand. A simple tabletop test—placing the hand flat on a surface—will reveal inability to fully extend affected fingers.

Treatment Options for Dupuytren’s Contracture

Mild cases may require no immediate intervention; monitoring the progression and protecting the hand from further stress are often recommended.

Active treatments focus on releasing the contracted tissue and improving finger movement:

1. Needle Aponeurotomy (Needling)

• A needle is inserted under local anesthesia to puncture and break the cords.

• No major incisions; can be performed in-office. Multiple fingers may be treated simultaneously.

• Fast recovery, but not suitable for all finger locations (risk of nerve/tendon injury); recurrence is possible.

2. Injections

• Steroid injections: Early nodules may soften and flatten after steroid shots, providing short-term pain and inflammation relief.

• Collagenase injections: An enzyme (collagenase) is injected to weaken the contracture cord. The finger is then manipulated to break the cord, restoring extension. Can last for years but is not always permanent.

3. Surgery

• Recommended for severe, longstanding contractures or recurrence after less invasive therapies.

• The surgeon removes the diseased tissue, with the most extensive cases requiring skin grafts.

• Surgery results in more complete, longer-lasting results but has a longer recovery period and greater risks.

Note: Any treatment may only provide temporary relief, and contracture recurrence is not uncommon.

Self-Care and Lifestyle Tips

• Use tools with built-up, padded handles to reduce hand strain.

• Wear protective gloves for heavy gripping.

• Perform hand exercises as advised by your provider to maintain flexibility.

Preparing for Your Appointment

• Document your family history, previous treatments, and medications.

• Note any increasing difficulty with daily activities, pain, or progression of symptoms.

• Expect questions about symptom history, progression, day-to-day challenges, and previous therapies tried.