If your fingers are starting to curl toward your palm and you can’t straighten them all the way, it could be Dupuytren’s contracture. This condition often develops slowly, over months or years. It may not need treatment right away but over time it can affect your ability to grip, hold objects or use your hand comfortably.
At Banner Health, our hand and wrist specialists help diagnose Dupuytren’s contracture early and offer treatment options that can help you move and use your hand better and maintain your quality of life.
Dupuytren’s contracture (Dupuytren’s disease) is a hand condition where thick tissue builds up under the skin of the palm. This tissue may form nodules (bumps) or cords (bands) that slowly pull one or more fingers toward the palm over time.
The condition develops in a layer of tissue that helps support the palm’s tendons, nerves and blood vessels. It most often affects the ring and pinky fingers, but it can affect other fingers as well.
You may have Dupuytren’s contracture in one or both hands, and symptoms can vary between hands and develop at different times.
It’s not clear exactly why the connective tissue in the palm thickens and tightens into nodules and cords that can pull your fingers into a bent position. Dupuytren’s contracture is believed to have a strong genetic link and often runs in families. It is more common in people of Northern European, especially Scandinavian, ancestry.
Some risk factors may increase your risk, including:
Dupuytren’s contracture symptoms may include:
You should see a health care specialist if:
Early evaluation can help you see what treatment options are available before your condition gets worse. If you only have small nodules in your palm without significant cords or finger bending, and you can still lay your hand flat on a table, you might not need treatment right away. But if the condition worsens, early treatment could help improve how your hand moves and functions.
Diagnosis is usually based on a physical exam. Your provider may:
You probably won’t need imaging tests unless your provider thinks you might have another condition. In that case, they may order X-rays or bloodwork.
Treatment depends on how severe your symptoms are and how much they affect your daily life. Some people only need monitoring. Others improve with injections, minimally invasive procedures or surgery to release tight cords.
In mild cases, your provider may monitor you to see if your symptoms get worse. These treatments may also help:
Needle aponeurotomy (needle fasciotomy) is a procedure that breaks up cords through the skin. It’s usually performed in a provider’s office or an outpatient surgery center. Your provider gives you local anesthesia, then uses a fine needle to weaken the cord. After that, they gently straighten your fingers.
You can generally use your hand for light activities right away, do desk work in a day or two and return to heavy gripping and lifting in one to three weeks. But for some, there can be a fair amount of swelling, and it may take longer to return to light work.
Depending on how the disease is affecting you and how severe it is, surgery could include:
You can usually have surgery performed as an outpatient procedure. Recovery can take weeks to months. You’ll probably need to wear a splint while you recover and do hand therapy exercises to regain your function, strength and flexibility.
Dupuytren’s contracture can be treated but not cured. After minimally invasive procedures, the contracture in the finger is more likely to come back than after surgery. Even if the cord is removed or treated in one finger, it can still occur in another finger on the same hand or in the opposite hand at any time.
If the contracture returns, it is usually monitored, and sometimes you may need treatment again. Symptoms can come back, so repeated treatment might be necessary.
Closely following your hand therapy and splinting plan after treatment can greatly improve your final range of motion. Ongoing care can help you keep your hand functioning well.
There is no proven way to prevent Dupuytren’s contracture. Most people develop it without any specific injury or job-related triggers.
Quitting smoking, limiting alcohol and controlling diabetes are important for your overall health, but they have not been proven to prevent Dupuytren’s from developing or returning.
It is usually not painful, but it can cause discomfort and limit hand function.
It often progresses slowly over the years, but the rate varies from person to person.
No, it does not go away without treatment. However, mild cases may not need treatment right away or ever because some people have little to no progression of the contracture over time.
The best treatment depends on how severe it is. Options range from injections to minimally invasive procedures or surgery.
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